Provider Demographics
NPI:1932227170
Name:JORDAN, JOYCE POPE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:POPE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 W MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4304
Mailing Address - Country:US
Mailing Address - Phone:919-872-1407
Mailing Address - Fax:919-870-8917
Practice Address - Street 1:280 W MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4304
Practice Address - Country:US
Practice Address - Phone:919-872-1407
Practice Address - Fax:919-870-8917
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0003821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC47446OtherPROVIDER NUMBER NCBCBS
NC131109OtherPROVIDER NUMBER VBH
NC221969OtherPROVIDER NUMBER COMPSYCH
NC221969OtherPROVIDER NUMBER COMPSYCH