Provider Demographics
NPI:1114560992
Name:JORDAN, BRANDEE R (LCSW-S)
Entity Type:Individual
Prefix:MRS
First Name:BRANDEE
Middle Name:R
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:MS
Other - First Name:BRANDEE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-S
Mailing Address - Street 1:1325 W NELSON ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4217
Mailing Address - Country:US
Mailing Address - Phone:903-624-1968
Mailing Address - Fax:
Practice Address - Street 1:1325 W NELSON ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4217
Practice Address - Country:US
Practice Address - Phone:903-624-1968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX590331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical