Individual
MICHAEL A JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
10015 OLD COLUMBIA RD, COLUMBIA, MD 21046-1703
(410) 551-2455
(866) 422-6096
Mailing address
1762 SEA PINE CIR, SEVERN, MD 21144-1815
(410) 551-2455
(866) 422-6096
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12789
MD
104100000X
Social Worker
LC50078552
DC
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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