Provider Demographics
NPI:1407525272
Name:WATSON, JORDAN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 ARMOUR DR NE STE E
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3975
Mailing Address - Country:US
Mailing Address - Phone:470-508-5436
Mailing Address - Fax:
Practice Address - Street 1:199 ARMOUR DR NE STE E
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3975
Practice Address - Country:US
Practice Address - Phone:470-508-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0102141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical