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Organization
TRACY JORDAN, LCSW-C
Active
Organization
TRACY JORDAN, LCSW-C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY SUZANNE JORDAN LCSW-C (LICENSED CLINICAL SOCIAL WORKER)
(410) 446-5678
Entity
Organization
Contact information
Practice address
9650 SANTIAGO RD STE 3, COLUMBIA, MD 21045-3960
(410) 446-5678
Mailing address
2190 OAK FOREST DR, ELLICOTT CITY, MD 21043-1966
(410) 446-5678
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12109
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122305
JOHNS HOPKINS HEALTHCARE
MD
Enumeration date
10/20/2010
Last updated
10/20/2010
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