Jordan Lewis Jefferson, AA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kahuku, HI
NPI 1285284232 · NPPES record last updated Sep 11, 2019
Key facts
- NPI
- 1285284232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 56-660 Kamehameha Hwy
Kahuku, HI 96731-2210 - Phone
- (808) 293-7555
- Fax
- (808) 293-7196
- NPI assigned
- Sep 11, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Associate of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
56-660 Kamehameha Hwy
Kahuku, HI 96731-2210
Mailing address
56-660 Kamehameha Hwy
Kahuku, HI 96731-2210
Phone (808) 293-7555
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Kahuku | Direct |
Other providers in Kahuku, HI
- Josephine MK Hood
- Natividad Camit Hopewell
- Helen P Hudson
- Jason Hughes
- Irene Hwang
- Kahuku Hospital
- Kahuku Hospital
- Kahuku Hospital Pharmacy
- Kahuku Medical Center
- Kahuku Medical Center
All providers in Kahuku, HI · Addiction (Substance Use Disorder) Counselor in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.