Provider Demographics
NPI:1467568626
Name:JORDAN, BARBARA W (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:W
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5656
Mailing Address - Country:US
Mailing Address - Phone:407-647-4656
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2115
Practice Address - Country:US
Practice Address - Phone:407-975-0416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 34991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6278099OtherUNITED HEALTH CARE
7893089OtherAETNA
FLZ7669OtherBLUE CROSS BLUE SHIELD
A349345OtherVALUEOPTIONS, INC.
2034311OtherCIGNA