Individual provider Active NPI

Jordan Wildman Fletcher

  • Professional Counselor
  • Durango, CO
National Provider Identifier
1396095006
Registry record updated Feb 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0013032 Issued in CO
Practice address
1125 Three Springs Blvd
Durango, CO 81301-9033
Phone
(970) 403-0180
NPI assigned
Sep 11, 2012
Last updated
Feb 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X LPC.0013032 CO Primary

Addresses

Primary practice location

1125 Three Springs Blvd
Durango, CO 81301-9033

Mailing address

150 Mercury Village Dr
Durango, CO 81301-8955

Other names 1

  • Jordan Elizabeth Wildman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130003346 CO Practitioner - Mental Health Counselor 5890143846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1125 Three Springs Blvd
Durango, CO 81301-9033
Phone (970) 403-0180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Colorado Mental Health Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Southwest Colorado Mental Health Center Inc Dba Axis Health System CurrentSince Jan 1, 2024 Accepting new patients
Southwest Colorado Mental Health Center, Inc Current Accepting new patients
Southwest Colorado Mental Health Center, Inc Past Accepting new patients
Southwest Colorado Mental Health Center, Inc Past Accepting new patients
Southwest Colorado Mental Health Center, Inc Past Accepting new patients

Locations

495 W 4th St
Dove Creek, CO 81324
Phone (970) 677-2291

1125 Three Springs Blvd
Durango, CO 81301
Phone (970) 403-0180

150 Mercury Village Dr
Durango, CO 81301
Phone (970) 335-2342

1970 E 3rd Ave
Ste 1
Durango, CO 81301
Phone (970) 335-2288

281 Sawyer Dr
Ste 100
Durango, CO 81303
Phone (970) 259-2162

300 N Cascade Ave
Ste A
Montrose, CO 81401
Phone (970) 252-3203

Interoperability endpoints

  • Direct secure messaging: jordan.fletcher.p1@direct.ahs.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770508800000",
    "number": "1396095006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MERCURY VILLAGE DR",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018955",
            "fax_number": "970-335-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813019033",
            "telephone_number": "970-403-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JORDAN",
        "middle_name": "WILDMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2026-02-08",
        "certification_date": "2026-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "WILDMAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.