Provider Demographics
NPI:1447957485
Name:JORDAN, CAILYN (LCSW)
Entity type:Individual
Prefix:
First Name:CAILYN
Middle Name:
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 1:600 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8643
Mailing Address - Country:US
Mailing Address - Phone:256-325-2627
Mailing Address - Fax:
Practice Address - Street 1:7101 US HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9512
Practice Address - Country:US
Practice Address - Phone:256-325-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2025-08-28
Deactivation Date:2024-08-16
Deactivation Code:
Reactivation Date:2025-02-04
Provider Licenses
StateLicense IDTaxonomies
AR11893-C1041C0700X
AL5888C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical