Provider Demographics
NPI:1558008359
Name:JORDAN, JOANNA MCSHAN (LMSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MCSHAN
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 GOLDMAR DR
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2810
Mailing Address - Country:US
Mailing Address - Phone:205-915-6112
Mailing Address - Fax:
Practice Address - Street 1:5204 GOLDMAR DR
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2810
Practice Address - Country:US
Practice Address - Phone:205-915-6112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5835G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker