Provider Demographics
NPI:1346075231
Name:JORDAN, AIMEE NICOLE (MSW, LGSW)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:NICOLE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CROSSWIND DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-9193
Mailing Address - Country:US
Mailing Address - Phone:304-363-3341
Mailing Address - Fax:304-363-3342
Practice Address - Street 1:3 CROSSWIND DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-9193
Practice Address - Country:US
Practice Address - Phone:304-894-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP009449521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical