Provider Demographics
NPI:1881579266
Name:GOODEN, JORDAN ELISE
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ELISE
Last Name:GOODEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 BRIGHAM RD APT 2D
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9023
Mailing Address - Country:US
Mailing Address - Phone:980-229-5580
Mailing Address - Fax:
Practice Address - Street 1:650 BRIGHAM RD APT 2D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9023
Practice Address - Country:US
Practice Address - Phone:980-229-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0207061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical