Provider Demographics
NPI:1558931162
Name:JORDAN, LINDSAY ELIZABETH (LCSWA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELIZABETH
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 CHAPEL HILL RD STE H
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5039
Mailing Address - Country:US
Mailing Address - Phone:919-228-8284
Mailing Address - Fax:
Practice Address - Street 1:7406 CHAPEL HILL RD STE H
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5039
Practice Address - Country:US
Practice Address - Phone:919-228-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0164371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical