Individual
MR. DARRELL JORDAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, DCSW
Contact information
Practice address
1020 CEDAR CREST DR, APT C-9, ABILENE, TX 79601-3714
(229) 395-0151
Mailing address
PO BOX 2433, ABILENE, TX 79604-2433
(229) 395-0151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1273-LCSW
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000663506
—
GA
Enumeration date
05/24/2007
Last updated
03/16/2010
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