Individual provider Active NPI

Lark Cheri Jordan, MA, LPC

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1104523869
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
84769 Issued in TX
Practice address
4144 N Central Expy Ste 850
Dallas, TX 75204-3226
Phone
(972) 865-8782
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 84769 TX Primary

Addresses

Primary practice location

4144 N Central Expy Ste 850
Dallas, TX 75204-3226

Mailing address

8650 Southwestern Blvd Apt 2805
Dallas, TX 75206-2685
Phone (214) 608-0259

Other names 1

  • Ms. Lark Cheri Pokladnik Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
84769TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1104523869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 SOUTHWESTERN BLVD APT 2805",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752062685",
            "telephone_number": "214-608-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 N CENTRAL EXPY STE 850",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043226",
            "telephone_number": "972-865-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LARK",
        "middle_name": "CHERI",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "84769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARK",
            "last_name": "POKLADNIK",
            "middle_name": "CHERI",
            "prefix": "MS.",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.