# JORDAN SIERRA PRUSSACK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1194350496
- **Gender:** F
- **Credential:** LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 18921 | SC | — |
| 1041C0700X | Clinical Social Worker | BBH-LCSW-LIC-33322 | MT | Yes |
| 1041C0700X | Clinical Social Worker | C016209 | NC | — |

## Other

- **Enumeration date:** 03/06/2020
- **Last updated:** 08/28/2026