Active NPI
Jordan Ellinwood
- Mental Health Counselor
- Spokane, WA
National Provider Identifier
1437624111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH6L287441
- Practice address
- 107 S Division St
Spokane, WA 99202-1510 - Phone
- (509) 838-4651
- NPI assigned
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61018064 | WA | |
| Counselor | 101Y00000X | CG61086898 | WA | |
| Behavior Technician | 106S00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | LH6L287441 | WA | Primary |
Addresses
Primary practice location
107 S Division St
Spokane, WA 99202-1510
Mailing address
107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651
Other practice location 1
1819 E Springfield Ave Ste H
Spokane, WA 99202-2954
Phone (509) 999-5657
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG61018064 | WA | MD | Counselor |
| CG61086898 | WA | MD | Counselor |
| LH6L287441 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650844800000",
"number": "1437624111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021510",
"telephone_number": "509-838-4651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 S DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021510",
"telephone_number": "509-838-4651"
}
],
"practiceLocations": [
{
"address_1": "1819 E Springfield Ave Ste H",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992022954",
"country_code": "US",
"telephone_number": "509-999-5657",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLINWOOD",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-09",
"last_updated": "2022-04-25",
"certification_date": "2022-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61018064",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61086898",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH6L287441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.