| Menyuan Jordan, LCSW | |
|
107 Enterprise Path Ste 300, Hiram, GA 30141-2690 | |
| (678) 588-7982 | |
| Not Available |
| Full Name | Menyuan Jordan |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 18 Years |
| Location | 107 Enterprise Path Ste 300, Hiram, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639839863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW007869 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sondermind Provider Network Llc | 9537572490 | 874 |
| Entity Name | Highland Rivers Community Service Board |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447256243 PECOS PAC ID: 9032000245 Enrollment ID: O20040324001204 |
| Entity Name | The Northrop Connection, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912398868 PECOS PAC ID: 6800104506 Enrollment ID: O20150929003498 |
| Entity Name | Sondermind Provider Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210225002747 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220315000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Menyuan Jordan, LCSW 107 Enterprise Path Ste 300, Hiram, GA 30141-2690 Ph: (678) 588-7982 | Menyuan Jordan, LCSW 107 Enterprise Path Ste 300, Hiram, GA 30141-2690 Ph: (678) 588-7982 |
Mrs. Shannon Davidson, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 126 Enterprise Path Ste 201, Hiram, GA 30141 Phone: 678-682-0405 | |
Timothy James Whailen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 107 Enterprise Path Ste 301, Hiram, GA 30141 Phone: 706-509-0130 Fax: 706-237-6503 | |
Edward Miguel Valentin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Enterprise Path Ste 104b, Hiram, GA 30141 Phone: 770-256-7078 |