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KATHY Q. JORDAN, LCSW, LLC
NPI 1467734400
Social Worker - Clinical in Fayetteville, AR

Active since September 15, 2011
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703(479) 443-5575(479) 443-9554 Get Directions Write a Review

NPPES record last updated: September 15, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kathy Q. Jordan, Lcsw, Llc NPPES

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

KATHY Q. JORDAN, LCSW, LLC (NPI 1467734400) is a healthcare organization registered as a clinical in Fayetteville, Arkansas and active in the NPI registry since September 2011. The organization lists Kathy Quarles Jordan, Owner, as its authorized official.

NPPES Registry Identity

NPI1467734400
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameKATHY Q. JORDAN, LLC
Location Address1 W SUNBRIDGE DRFayetteville, AR 72703-1825
Mailing Address1 W Sunbridge DrFayetteville, AR 72703-1825 · (479) 443-5575 · Fax (479) 443-9554
Phone(479) 443-5575
Fax(479) 443-9554
Organization SubpartNo
Authorized OfficialKathy Quarles JordanOwner · (479) 443-5575
Enumeration DateSeptember 15, 2011
✔ NPI 1467734400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in AR · 1573-C
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1 W SUNBRIDGE DR, Fayetteville, AR 72703
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Other Names 1

Doing Business AsKathy Q. Jordan, Lcsw, Llc

Other Identifiers 1

Other1881623197Individual Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathy Q. Jordan, Lcsw, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kathy Q. Jordan, Lcsw, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kathy Jordan, LCSW
Clinical Social Worker
NPI 1881623197
12 W. SUNBRIDGE
Fayetteville, AR 72703
(479) 750-2020
✔ PECOS0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kathy Q. Jordan, LLC's NPI number?

The NPI number for Kathy Q. Jordan, LLC is 1467734400. It was assigned to this organization in the NPPES registry on September 15, 2011. The provider is doing business as Kathy Q. Jordan, Lcsw, LLC.

Where is Kathy Q. Jordan, LLC located?

Kathy Q. Jordan, LLC is located at 1 W Sunbridge Dr, Fayetteville, AR 72703. The listed phone number is (479) 443-5575.

What is Kathy Q. Jordan, LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kathy Q. Jordan, LLC enrolled in Medicare?

Yes. Kathy Q. Jordan, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kathy Q. Jordan, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Kathy Q. Jordan, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kathy Q. Jordan, LLC was last updated on September 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.