Individual provider Active NPI

Jordan Craig Gabel, B.S. PSYCHOLOGY

  • Addiction (Substance Use Disorder) Counselor
  • Campbellsville, KY
National Provider Identifier
1114742004
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
830 W Broadway St
Campbellsville, KY 42718-2701
Phone
(745) 093-4866
NPI assigned
Nov 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X KY
Addiction (Substance Use Disorder) Psychologist 103TA0400X KY
Addiction (Substance Use Disorder) Counselor 101YA0400X KY Primary

Addresses

Primary practice location

830 W Broadway St
Campbellsville, KY 42718-2701

Mailing address

214 E Walnut St
Campbellsville, KY 42718-1232
Phone (270) 283-0309

Other names 1

  • Mr. Jordan Craig Gabel Professional 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
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1114742004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E WALNUT ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181232",
            "telephone_number": "270-283-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 W BROADWAY ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182701",
            "telephone_number": "745-093-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABEL",
        "first_name": "JORDAN",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "B.S. PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "GABEL",
            "middle_name": "CRAIG",
            "prefix": "MR.",
            "credential": "CADC (TRAINEE)",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.