Provider Demographics
NPI:1235116930
Name:JORDAN, DARLENE PAPA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:PAPA
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DARLENE
Other - Middle Name:DOMENICA
Other - Last Name:PAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1500 SHALLCROSS AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-3037
Mailing Address - Country:US
Mailing Address - Phone:302-743-2984
Mailing Address - Fax:302-326-0664
Practice Address - Street 1:1500 SHALLCROSS AVE
Practice Address - Street 2:STE 2
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-3037
Practice Address - Country:US
Practice Address - Phone:302-743-2984
Practice Address - Fax:302-326-0664
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-0000749101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor