Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Michael Peterson Stephan, LSW

Individual provider Clinical Social Worker · NPI 1700642774

Jordan Michael Peterson Stephan, LSW is a Clinical Social Worker in Fort Wayne, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2024
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

10016 Monticello Blvd
Fort Wayne, IN 46825-2193
Phone: (920) 379-5728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 33011238A (IN)

Record details

NPI number1700642774
Entity typeIndividual (Type 1)
GenderMale
Credentials LSW
Sole proprietorYes
NPI enumeratedFebruary 26, 2024
Last updated in NPPESFebruary 26, 2024
Certification dateFebruary 26, 2024

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