JORDAN TABB (NPI# 1780010041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780010041 |
| Entity Type | Individual |
| Full Name | JORDAN TABB |
| Credential | LCSW |
| Practice Address |
721 Stedman St Ketchikan AK 99901-6632 |
| Practice Telephone | (907) 225-7825 |
| Practice Fax Number | 9072251541 |
| Mailing Telephone | (907) 225-7825 |
| Mailing Fax Number | 9072251541 |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2017-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | LMSW-33260 | ID | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
113550 | AK | Behavioral Health & Social Service Providers |
| Street Address |
721 STEDMAN ST |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-6632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356434542 | Terry Wayne Fouts | Social Worker | 721 Stedman St, Ketchikan, AK 99901-6632 | 2006-10-02 |
| 1568061232 | Community Connections | Community/Behavioral Health | 721 Stedman St, Ketchikan, AK 99901-6632 | 2020-10-22 |
| 1598289670 | Mindy Trozelle | Specialist/Technologist | 721 Stedman St, Ketchikan, AK 99901-6632 | 2017-07-31 |
| 1720519663 | Cecilia Chandler | Speech-Language Pathologist | 721 Stedman St, Ketchikan, AK 99901-6632 | 2017-03-22 |
| 1710418769 | Karen Stafford | Speech-Language Pathologist | 721 Stedman St, Ketchikan, AK 99901-6632 | 2017-03-22 |
| 1164877437 | Rebecca Moon | Counselor | 721 Stedman St, Ketchikan, AK 99901-6632 | 2016-04-25 |
| 1952713430 | Kathleen Kloep | Case Manager/Care Coordinator | 721 Stedman St, Ketchikan, AK 99901-6632 | 2014-06-02 |
| 1861804338 | Sharyl Yeisley | Case Manager/Care Coordinator | 721 Stedman St, Ketchikan, AK 99901-6632 | 2014-06-02 |
| 1093998163 | Community Connections | Home Health | 721 Stedman St, Ketchikan, AK 99901-6632 | 2007-12-12 |
| 1801079975 | Community Connections | Early Intervention Provider Agency | 721 Stedman St, Ketchikan, AK 99901-6632 | 2007-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| 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 |
|---|---|---|---|---|
| 1205265170 | Mary C Eberle | Social Worker | 540 Water St Ste 202, Ketchikan, AK 99901-6378 | 2013-11-01 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1811026693 | Patricia Anne Hauser | Social Worker | 4079 Tongass Ave Ste 200, Ketchikan, AK 99901-5526 | 2007-03-05 |
| 1013404383 | Rainwood Counseling LLC | Social Worker | 540 Water St Ste 202, Ketchikan, AK 99901-6378 | 2018-04-22 |
| 1346535457 | Patti Green | Social Worker | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2011-06-16 |
| 1750521449 | Stephanie M Lively | Social Worker | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2009-02-20 |
| 1083746432 | Jasmine F. Stewart | Social Worker | 2960 Tongass Ave, Suite 403, Ketchikan, AK 99901-5742 | 2007-03-12 |
| 1922130566 | Esperanza M. Redelfs | Social Worker | 2960 Tongass Ave, Suite 403, Ketchikan, AK 99901-5742 | 2007-03-09 |
| 1245362870 | William S. Hardy | Social Worker | 2960 Tongass Ave, Suite 403, Ketchikan, AK 99901-5742 | 2007-03-09 |
| 1679644322 | Donna Jean Scarborough | Social Worker | 3050 5th Ave, Ketchikan, AK 99901-5773 | 2006-11-13 |
| Find all providers in KETCHIKAN | ||||
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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.