Provider Demographics
NPI:1699224899
Name:JORDEN, CASEY (MSW, SWC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:JORDEN
Suffix:
Gender:F
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4694 CHATHAM ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-4032
Mailing Address - Country:US
Mailing Address - Phone:541-508-6080
Mailing Address - Fax:
Practice Address - Street 1:9143 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-4819
Practice Address - Country:US
Practice Address - Phone:541-508-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR283234Medicaid