JORDAN KIELISZEWSKI (NPI# 1669469094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669469094 |
| Entity Type | Individual |
| Full Name | JORDAN KIELISZEWSKI |
| Credential | LISWS |
| Practice Address |
1090 Arnold Dr Jacksonville AR 72099 |
| Mailing Address |
1090 Arnold Dr Jacksonville AR 72099-4933 |
| Practice Telephone | 5019877338 |
| Mailing Telephone | 5019877338 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
S32150 | OH | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5955 Zeamer Ave, Jber, AK 99506 | 9075802181 |
| Street Address |
1090 ARNOLD DR |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003319880 | Isaac Clayton Talbert | Preventive Medicine | 1090 Arnold Dr, Jacksonville, AR 72099 | 2018-03-17 |
| 1851806350 | Dewayne Lamon Sora | Social Worker | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2017-12-06 |
| 1134633654 | Brandy Shannon Williams | Physician Assistant | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2017-11-20 |
| 1679025795 | Claudia Irene Sloan | Military Health Care Provider | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2016-10-25 |
| 1568918837 | Bradley Phares | Dentist | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2016-08-28 |
| 1730594342 | Tameka Henry | Nurse Practitioner | 1090 Arnold Dr, Jacksonville, AR 72099-7274 | 2014-06-23 |
| 1841559960 | Lenard Tol | Physician Assistant | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2012-05-09 |
| 1013282086 | Tanya Nashel Miller | Counselor | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2012-03-09 |
| 1154480622 | Amanda Gail Bellamy | Pharmacist | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2006-12-08 |
| 1336139385 | Leonardo Tato | Physician Assistant | 1090 Arnold Dr, Jacksonville, AR 72099-0001 | 2005-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356876577 | Little Rock Air Force Base Eye Care | Optometrist | 6th Street, Bldg 787, Little Rock Air Force Base, Little Rock, AR 72099 | 2017-04-25 |
| 1841636206 | National Vision Optical | Technician/Technologist | Bldg 787 6th St., Little Rock, AR 72099 | 2013-05-13 |
| 1134341076 | Keisha Denythia Henry | Psychologist | 314 Medical Group, Life Skills Support Center, 1090 Arnold Drive, Little Rock Afb, AR 72099 | 2007-05-02 |
| 1699213454 | Teryn Ardell Freeman | Physician Assistant | 19th Medical Group, 1090 Arnold Drive, Little Rock, AR 72099 | 2017-02-01 |
| 1730314899 | Andrew Chichick Iv | Military Health Care Provider | 1090 Arnold Drive, 19 Amds/sgpf, Little Rock Afb, AR 72099 | 2009-05-19 |
| 1427316488 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 6 Th St Bldg 787, Little Rock Afb, AR 72099-0001 | 2012-04-27 |
| 1700174828 | Lewis Mark Wiggins | Family Medicine | 19th Medical Group, Jacksonville, AR 72099-0001 | 2011-07-11 |
| 1104052158 | Seth Thomas Tolliver | Nurse Practitioner | 101 Master Sergeant Dan Wassom, Little Rock Afb, AR 72099-0001 | 2009-06-04 |
| 1316171994 | Jeff J. Sandoval | Military Health Care Provider | 19 Amds Sgopf, 1090 Arnold Dr, Little Rock Afb, AR 72099-0001 | 2009-05-11 |
| 1366610198 | Robert Anthony Olivi Jr. | Physician Assistant | 19th Medical Group 1090 Arnold Drive, Little Rock Air Force Base, AR 72099-0001 | 2008-02-14 |
| Find all providers in zip 72099 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748193 | Sophia Venditti | Social Worker | 2598 Post St # 1, Jacksonville, FL 32204-4256 | 2020-10-22 |
| 1629676093 | My Journey, LLC | Social Worker | 13453 N Main St Ste 204, Jacksonville, FL 32218-2773 | 2020-10-16 |
| 1104423524 | Sonya Young | Social Worker | 920 Bridier St, Jacksonville, FL 32206-5904 | 2020-10-08 |
| 1043823115 | Sierra Lashonda Murray | Social Worker | 9246 Thunderbolt Dr, Jacksonville, FL 32221-8052 | 2020-08-28 |
| 1235741901 | Deidra Lewis | Social Worker | 4480 Deerwood Lake Pkwy Unit 134, Jacksonville, FL 32216-2255 | 2020-08-23 |
| 1497365456 | Darlene Denise Rolle- Cargill | Social Worker | 14050 Integra Dr Apt 420, Jacksonville, FL 32218-2592 | 2020-08-05 |
| 1689282626 | Andrea Kristin Perkinson | Social Worker | 128 Plow Point Ln, Jacksonville, NC 28546-9591 | 2020-07-15 |
| 1255956371 | Noel Roman | Social Worker | 11775 Carson Lake Dr W, Jacksonville, FL 32221-3812 | 2020-06-15 |
| 1285257535 | Phaith Coaching & Counseling, LLC | Social Worker | 4940 Emerson St, Jacksonville, FL 32207-4963 | 2020-05-21 |
| 1407478613 | Mara's Lighthouse Counseling Center, LLC | Social Worker | 6015 Morrow St E Ste 114, Jacksonville, FL 32217-2125 | 2020-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72099 |
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| 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.