Provider Demographics
NPI:1568836997
Name:JORDAN, ROBIN L (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
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 1:3109 GARDNER BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-9767
Mailing Address - Country:US
Mailing Address - Phone:502-689-1613
Mailing Address - Fax:
Practice Address - Street 1:2950 BRECKENRIDGE LN STE 10A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1495
Practice Address - Country:US
Practice Address - Phone:502-689-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2532551041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical