Jordan Gavin Horniak, BS, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

305535 Issued in MN

Practice address

1404 Central Ave NE
Minneapolis, MN 55413-1517

Phone

(612) 594-8146

Fax

(612) 789-8087

NPI assigned

Oct 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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.

• Nuway Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1013608405

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1215534771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 KENZIE TER APT 128",
            "city": "SAINT ANTHONY",
            "state": "MN",
            "postal_code": "554184153",
            "telephone_number": "612-998-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131517",
            "telephone_number": "612-594-8146",
            "fax_number": "612-789-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNIAK",
        "first_name": "JORDAN",
        "middle_name": "GAVIN",
        "credential": "BS, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOTHING",
            "identifier": "NOTHING",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan.horniak@nuway.org",
            "affiliation": "N",
            "endpointDescription": "work",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1404 Central Ave NE",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554131517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Dennis Horn, MD
• Jacquelyn Munson Horn
• Anna Charlotte Hornbach
• Andrew James Horne, RN, PHN
• Ryan Ruben Horne, MD, PHD
• Ruth Ann Hornstein, PSY.D.
• Patricia M Hornung, APRN, CNP
• Emily Helen Anne Horsey, L.I.C.S.W.
• Hani Horssa
• Brian Horst, M.D.

• Addiction (Substance Use Disorder) Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.