Provider Demographics
NPI:1568836997
Name:JORDAN, ROBIN L (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIRACLE STRIP LOOP STE 15
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-8410
Mailing Address - Country:US
Mailing Address - Phone:850-235-8495
Mailing Address - Fax:
Practice Address - Street 1:5 MIRACLE STRIP LOOP STE 15
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-8410
Practice Address - Country:US
Practice Address - Phone:850-235-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW222291041C0700X
IN34008227A1041C0700X
KY2532551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical