Provider Demographics
NPI:1699352971
Name:PYLANT, JORDAN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:
Last Name:PYLANT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:123 GRETZKY PKWY
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-9584
Mailing Address - Country:US
Mailing Address - Phone:919-343-5281
Mailing Address - Fax:
Practice Address - Street 1:123 GRETZKY PKWY
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-9584
Practice Address - Country:US
Practice Address - Phone:919-343-5281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0144991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty