DR. SHIRLEY JEAN JORDAN (NPI# 1619177409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619177409 |
| Entity Type | Individual |
| Full Name | DR. SHIRLEY JEAN JORDAN |
| Credential | PH.D. |
| Practice Address |
506 N Miller St Decatur TX 76234-1114 |
| Mailing Address |
504 N Miller St Decatur TX 76234-1114 |
| Practice Telephone | 9406271690 |
| Mailing Telephone | 9406271690 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
2-3168 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1132268-0 | 05 |
| Street Address |
506 N MILLER ST |
| City | DECATUR |
| State | TX |
| Zip Code | 76234-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598098949 | Lynyetta G Willis | Psychologist | 308 Clairemont Ave, Decatur, GA 30030-2506 | 2009-09-16 |
| 1245285295 | Mark Jacob | Psychologist | 801 Church Street, Suite 1, Decatur, AL 35602 | 2006-05-24 |
| 1952393308 | Michal Ann O'leary | Psychologist | 1945 Mason Mill Rd, Suite 100, Decatur, GA 30033-4006 | 2005-08-20 |
| 1548269418 | Cynthia Kay Valley | Psychologist | 1549 Clairmont Rd, Suite 108, Decatur, GA 30033-4639 | 2005-07-21 |
| 1841807591 | Mallorie Gayle Carroll | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-28 |
| 1164036570 | Rachel Heatherly | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-02 |
| 1033462486 | Karuna Counseling, Inc. | Psychologist | 1945 Mason Mill Rd Ste 100, Decatur, GA 30033-4075 | 2012-10-23 |
| 1093087876 | Kathryn Ganske | Psychologist | 1549 Clairmont Rd, Suite 108, Decatur, GA 30033-4639 | 2012-02-08 |
| 1073807608 | Alaycia Deneen Reid | Psychologist | 315 W Ponce De Leon Ave, Decatur Court, Suite 552, Decatur, GA 30030-2400 | 2011-05-31 |
| 1801192661 | Luis Felipe Valdes | Psychologist | 2785 Lawrenceville Hwy, Suite 108, Decatur, GA 30033-2515 | 2011-01-26 |
| Find all providers in DECATUR | ||||
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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.