SAMANTHA R JORDAN PSYD
NPI 1366786527
Psychologist in Marietta, GA

Active since November 12, 2012Accepts Medicare Assignment
2520 WINDY HILL RD SE, SUITE 203, MARIETTA, GA 30067(770) 953-6401(770) 953-6015 Get Directions Write a Review

NPPES record last updated: November 12, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samantha R Jordan Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA R JORDAN PSYD (NPI 1366786527) is an individual psychologist in Marietta, Georgia, licensed in Georgia (PSY003632) and active in the NPI registry since November 2012. She is a graduate of Other (2007).

NPPES Registry Identity

NPI1366786527
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSAMANTHA R JORDANCredential: PSYD
Location Address2520 WINDY HILL RD SE, SUITE 203Marietta, GA 30067-8664
Mailing Address2520 Windy Hill Rd Se, Suite 203Marietta, GA 30067-8664 · (770) 953-6401 · Fax (770) 953-6015
Fax(770) 953-6015
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateNovember 12, 2012
NPI 1366786527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in GA · PSY003632
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
2520 WINDY HILL RD SE, Marietta, GA 30067

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Samantha R Jordan Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244556975
PECOS Enrollment IDI20150224000696

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Orthopaedic Surgery
2520 WINDY HILL RD SE, SUITE 202
MARIETTA, GA 30067
Family Medicine
2520 WINDY HILL RD SE, SUITE 301
MARIETTA, GA 30067
Clinic/Center (Podiatric)
2520 WINDY HILL RD SE, SUITE 105
MARIETTA, GA 30067
Psychologist
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Psychologist
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Psychologist (Clinical)
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Nurse Practitioner (Pediatrics)
2520 WINDY HILL RD SE, SUITE NUMBER 104
MARIETTA, GA 30067
Internal Medicine (Gastroenterology)
2520 WINDY HILL RD SE, SUITE 102
MARIETTA, GA 30067

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Jordan's NPI number?

The NPI number for Samantha Jordan is 1366786527. It was assigned to this individual provider in the NPPES registry on November 12, 2012.

Where is Samantha Jordan located?

Samantha Jordan practices at 2520 Windy Hill Rd SE Suite 203, Marietta, GA 30067. The listed phone number is (770) 953-6401.

What is Samantha Jordan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Samantha Jordan enrolled in Medicare?

Yes. Samantha Jordan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Samantha Jordan was last updated on November 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.