Individual provider Active NPI

Jordan McDonald Morin

  • Professional Counselor
  • Corpus Christi, TX
National Provider Identifier
1033563564
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
72779 Issued in TX
Practice address
1630 S Brownlee Blvd
Corpus Christi, TX 78404-3134
Phone
(361) 980-9652
Fax
(361) 993-8509
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 72779 TX Primary

Addresses

Primary practice location

1630 S Brownlee Blvd
Corpus Christi, TX 78404-3134

Mailing address

5151 Flynn Pkwy Ste 506
Corpus Christi, TX 78411-4392
Phone (361) 688-2896

Other identifiers 1

IdentifierTypeStateIssuer
72779OtherTXTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
72779TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Counseling and Consulting, LLC Professional CurrentSince Mar 21, 2021 Accepting new patients

Locations

5151 Flynn Pkwy
Ste 506
Corpus Christi, TX 78411
Phone (361) 271-3130

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1033563564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 FLYNN PKWY STE 506",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114392",
            "telephone_number": "361-688-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 S BROWNLEE BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043134",
            "telephone_number": "361-980-9652",
            "fax_number": "361-993-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIN",
        "first_name": "JORDAN",
        "middle_name": "MCDONALD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
            "identifier": "72779",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.