Provider Demographics
NPI:1154140622
Name:WORTHINGTON, JOURDAN (LSW)
Entity type:Individual
Prefix:
First Name:JOURDAN
Middle Name:
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5642 KIOWA CIR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7058
Mailing Address - Country:US
Mailing Address - Phone:812-449-7227
Mailing Address - Fax:
Practice Address - Street 1:5642 KIOWA CIR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7058
Practice Address - Country:US
Practice Address - Phone:812-449-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker