BRENDA JORDAN (NPI# 1447723549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447723549 |
| Entity Type | Individual |
| Full Name | BRENDA JORDAN |
| Practice Address |
2392 Edgewood Ave N Jacksonville FL 32254-1725 |
| Practice Telephone | 9047817797 |
| Practice Fax Number | 9047817797 |
| Mailing Telephone | 9047817797 |
| Mailing Fax Number | 9047817797 |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235339136 | Brenda Mae Jordan | Specialist | 6619 S Lawrence St, Tacoma, WA 98409-4012 | 2007-07-19 |
| 1659620003 | Brenda Jordan | Pathology | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2012-08-30 |
| 1245487735 | Brenda Jordan | Social Worker | 16318 Jamaica Ave, Jamaica, NY 11432-4901 | 2008-08-26 |
| 1275720823 | Brenda Jordan | Counselor | 4023 Marine Ave, Lawndale, CA 90260-1840 | 2007-09-27 |
| 1235158619 | Brenda Louva Jordan | Nurse Practitioner | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-07-18 |
| Street Address |
2392 EDGEWOOD AVE N |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32254-1725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023016839 | Northwest Behavioral Health Services, Inc. | Case Management | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2005-07-14 |
| 1073110508 | Tia Denise Womack | Counselor | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-10-07 |
| 1073128088 | Catherine Knight | Counselor | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-09-15 |
| 1063022374 | Denzal Dillard | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-08-03 |
| 1447860663 | Shawnee Kereenyaga | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-08-03 |
| 1851919641 | Titus L Kent Sr. | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-07-08 |
| 1558999722 | Antia R Henderson | Case Manager/Care Coordinator | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-04-01 |
| 1992331011 | Northwest Behavioral Health | Case Management | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-03-20 |
| 1588294086 | Beatrice I Elias | Counselor | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-01-23 |
| 1063052421 | Kimberly Eugenia Ruise | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2020-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730673385 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 W Palm Ave Ste 210, Jacksonville, FL 32254 | 2018-06-18 |
| 1578072112 | Jules M Jean-pierre | Counselor | 2392 North Edgewood Avenue, Jacksonville, FL 32254 | 2017-09-27 |
| 1356869051 | Volaura Shanae Anderson | Counselor | 590 Ellis Rd, Jacksonville, FL 32254 | 2017-09-01 |
| 1962928291 | Angel Spivie | Counselor | 590 Ellis Road South Building 4, Jacksonville, FL 32254 | 2017-08-18 |
| 1376072777 | Tarkeshia Shuman | Contractor | 3150 Broadway Ave, Jacksoville, FL 32254 | 2017-06-08 |
| 1770931636 | Mamie Faith Peterson-mclaurn | Home Health | 2747 Sophia St, Jax, FL 32254 | 2016-06-01 |
| 1760803373 | Marian Lavonne Jones | Custodial Care Facility | 3501 Centerhill Dr. North, Jacksonville, FL 32254 | 2013-12-27 |
| 1659543981 | Monique Bosque-perez | Family Medicine | 781 Edgewood Ave N, Ufjp Commonwealth Family Practice, Jacksonville, FL 32254 | 2008-03-26 |
| 1508906652 | James Keith Riesz | Physical Therapist | 800 Lomax Street, Suite 105, Jacksonville, FL 32254 | 2007-02-07 |
| 1003903865 | Sabrina F Sessions | Pharmacist | 5050 Edgewood Court, Jacksonville, FL 32254 | 2006-10-05 |
| Find all providers in zip 32254 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104436963 | Cassandra Hert | Developmental Therapist | 13738 Alesbury Ct, Jacksonville, FL 32224-2236 | 2020-08-06 |
| 1710543897 | Angela Marie Simons | Developmental Therapist | 14030 Ivylgail Dr N, Jacksonville, FL 32225-2024 | 2019-05-14 |
| 1861954950 | Darnise Lashelle Price | Developmental Therapist | 18 Woodbriar Dr, Jacksonville, AR 72076-5365 | 2019-04-05 |
| 1255804977 | Christina Maton | Developmental Therapist | 11041 Ridge Point Dr, Jacksonville, FL 32257-3717 | 2019-01-04 |
| 1811415847 | Kimberly Armstrong | Developmental Therapist | 1206 Turtle Creek Dr. S, Jacksonville, FL 32218 | 2017-08-30 |
| 1407395205 | Mary Christina Bush | Developmental Therapist | 1274 Surfway Ct, Jacksonville, FL 32233-2241 | 2017-02-14 |
| 1922554575 | Lavoris Andrew Mobley | Developmental Therapist | 9000 Cypress Green Drive, Jacksonville, FL 32256 | 2016-09-01 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1134676711 | Katelyn Luksha | Developmental Therapist | 6867 Southpoiont Drive North, Jacksonville, FL 32216 | 2016-09-01 |
| 1780057794 | Nicole Terry | Developmental Therapist | 3610 N Ride Dr, Jacksonville, FL 32223-7489 | 2015-11-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32254 |
Please comment or provide details below to improve the information on BRENDA JORDAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.