Active NPI
Deborah Ann Jordan, M.ED.
- Mental Health Counselor
- Tacoma, WA
National Provider Identifier
1508914714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00003650
- Practice address
- 1019 Pacific Ave
Suite 1121
Tacoma, WA 98402-4443 - Phone
- (253) 272-9762
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00003650 | WA | Primary |
Addresses
Primary practice location
1019 Pacific Ave
Suite 1121
Tacoma, WA 98402-4443
Mailing address
1019 Pacific Ave
Suite 1121
Tacoma, WA 98402-4443
Phone (253) 272-9762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00003650 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508914714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 PACIFIC AVE",
"address_2": "SUITE 1121",
"city": "TACOMA",
"state": "WA",
"postal_code": "984024443",
"telephone_number": "253-272-9762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 PACIFIC AVE",
"address_2": "SUITE 1121",
"city": "TACOMA",
"state": "WA",
"postal_code": "984024443",
"telephone_number": "253-272-9762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "DEBORAH",
"middle_name": "ANN",
"credential": "M.ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00003650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.