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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

BOBBY WAYNE JORDAN ADC
NPI 1720991953
Counselor - Addiction (Substance Use Disorder) in Myrtle Beach, SC

Active since September 28, 2026
1607 EXECUTIVE AVE, MYRTLE BEACH, SC 29577(843) 712-7316(843) 945-1022 Get Directions Write a Review

NPPES record added: September 28, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Bobby Wayne Jordan Adc NPPES

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

BOBBY WAYNE JORDAN ADC (NPI 1720991953) is an individual addiction (substance use disorder) provider in Myrtle Beach, South Carolina and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1720991953
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameBOBBY WAYNE JORDANCredential: ADC
Location Address1607 EXECUTIVE AVEMyrtle Beach, SC 29577-6501
Mailing Address4600 Montgomery Rd Ste 400Cincinnati, OH 45212-2600 · (833) 510-4357 · Fax (866) 460-2997
Phone(843) 712-7316
Fax(843) 945-1022
Sole ProprietorNo
Enumeration DateSeptember 28, 2026
NPPES CertifiedSeptember 28, 2026
✔ NPI 1720991953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1607 EXECUTIVE AVE, Myrtle Beach, SC 29577
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Other Providers at the Same Location NPPES 8

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

LISA JOSEPHINE DESTEFANO MA
Counselor (Addiction (Substance Use Disorder))
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
AMY PETERSON
Licensed Practical Nurse
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
MEAGAN HILBURN FNP-C
Nurse Practitioner (Family)
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
BLAKE ELIZABETH THOMPSON ADC-IP
Counselor (Addiction (Substance Use Disorder))
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
TIFFANY CLARK PHARMACY TECHNICIAN
Pharmacy Technician
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
KELLY LYNN UNDERWOOD
Counselor (Addiction (Substance Use Disorder))
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
KEVIN ALEXANDER CALDWELL
Counselor (Addiction (Substance Use Disorder))
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316
MYRTLE BEACH TREATMENT SPECIALISTS LLC
Clinic/Center (Methadone)
1607 EXECUTIVE AVE
MYRTLE BEACH, SC 29577
Horry County (843) 712-7316

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 Bobby Jordan's NPI number?

The NPI number for Bobby Jordan is 1720991953. It was assigned to this individual provider in the NPPES registry on September 28, 2026.

Where is Bobby Jordan located?

Bobby Jordan practices at 1607 Executive Ave, Myrtle Beach, SC 29577. The listed phone number is (843) 712-7316.

What is Bobby Jordan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Bobby Jordan was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days 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.