Jaclyn Johndrow, LPC S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5937 Issued in OK

Practice address

1608 E Granger St
Broken Arrow, OK 74012-8311

Phone

(918) 381-5292

NPI assigned

May 21, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• At Peace Mental Health PLLC

  • Mental Health Counselor
  • Tulsa, OK
  • NPI 1780332635
  NPD Authorized official

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1154767812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 E GRANGER ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128311",
            "telephone_number": "918-381-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 E GRANGER ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128311",
            "telephone_number": "918-381-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNDROW",
        "first_name": "JACLYN",
        "credential": "LPC S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "5937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerson Taylor Jewart
• Catherine Grace Jezek, COTA/L
• Luis Alfonse Jimenez Rincon
• Joanna Peterson Lactation Consulting
• Joe Speer, MD, LLC
• Johnny Starkey DDS, PC
• Samantha Johns, RBT
• Amber Un-Hui Johnson
• Eugenia Johnson
• Grace Ann Johnson

• Mental Health Counselor in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.