Jordan Andrea Green | Tulsa, OK • PECOS Search

Jordan Andrea Green

Social Worker

Behavioral Health & Social Service Providers

6216 S Lewis Ave Ste 180, Tulsa, OK 74136-1077

(918) 960-7852 (918) 587-9471

PECOS Enrollment

Based on the most recent information from CMS, provider Jordan Andrea Green does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1578930210
Provider Type
Individual
Full Name
Green, Jordan Andrea
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/28/2015
Last Updated
3/9/2021

Contact Information

Practice Location

6216 S Lewis Ave Ste 180, Tulsa, OK 74136-1077

(539) 664-5738

Mailing Location

650 S Peoria Ave, Tulsa, OK 74120-4429

(918) 560-1399

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6205 Oklahoma