Organization
KATHY Q. JORDAN, LLC
Active
Organization
KATHY Q. JORDAN, LLC
Active
Other names
Kathy Q. Jordan, LCSW, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY QUARLES JORDAN LCSW (OWNER)
(479) 443-5575
Entity
Organization
Contact information
Practice address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 443-5575
(479) 443-9554
Mailing address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 443-5575
(479) 443-9554
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1573-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881623197
INDIVIDUAL NPI
—
Enumeration date
09/15/2011
Last updated
09/15/2011
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