Jordan M Edmondson

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JORDAN M EDMONDSON

Practice address

2120 Foxglove CT
Forney, TX 75126-6360

Phone

(214) 763-8584

NPI assigned

Jan 28, 2019

Organization subpart

No

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

Authorized official

Name

Jordan Degraftenreed, LPC

Title

LPC

Phone

(214) 763-8584

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Michael Edmondson, LPC

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1679044812
  NPD

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1558825174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 FOXGLOVE CT",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751266360",
            "telephone_number": "214-763-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 FOXGLOVE CT",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751266360",
            "telephone_number": "214-763-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN M EDMONDSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "DEGRAFTENREED",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "214-763-8584",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Forney, TX
• Providers in Forney, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.