Individual provider Active NPI

Jordan Buckthorpe, LPC

  • Professional Counselor
  • Cape Girardeau, MO
National Provider Identifier
1083253561
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2019044933 Issued in MO
Practice address
402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone
(573) 334-1100
Fax
(573) 651-4345
NPI assigned
Dec 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 2019044933 MO Primary

Addresses

Primary practice location

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536

Mailing address

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone (573) 334-1100

Other names 1

  • Miss Jordan Seyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231128000781 MO Practitioner - Mental Health Counselor 2163870478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Counseling CenterGroup PAC ID 9436142460, 22 clinicians

Practice addresses (Care Compare)

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone 57333411002780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

402 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 334-1100

820 Park Dr
Ste Genevieve, MO 63670
Phone (573) 883-7407

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": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1083253561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-651-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-651-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKTHORPE",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2019044933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "SEYER",
            "prefix": "MISS",
            "credential": "PLPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.