Provider Demographics
NPI:1750424982
Name:JORDAN, JENNIFER LESLIE (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LESLIE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LESLIE
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:23402 BARTH SPRING LN
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-1940
Mailing Address - Country:US
Mailing Address - Phone:301-824-2697
Mailing Address - Fax:
Practice Address - Street 1:5229 NEW DESIGN RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7103
Practice Address - Country:US
Practice Address - Phone:301-668-1320
Practice Address - Fax:301-696-1390
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical