Individual provider Active NPI

Markelse Jordan, LPC

  • Professional Counselor
  • Irving, TX
National Provider Identifier
1578155198
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74730 Issued in TX
Practice address
2928 N Belt Line Rd
Irving, TX 75062-5247
Phone
(214) 307-7786
NPI assigned
Feb 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 74730 TX Primary

Addresses

Primary practice location

2928 N Belt Line Rd
Irving, TX 75062-5247

Mailing address

10818 Stone Canyon Rd Apt 3215
Dallas, TX 75230-6213
Phone (214) 404-5055

Other practice location 1

10818 Stone Canyon Rd Apt 3215
Dallas, TX 75230-6213
Phone (214) 404-5055

Other practice location 2

1350 N Buckner Blvd Ste 100
Dallas, TX 75218-3591
Phone (214) 404-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240412000622 TX Practitioner - Mental Health Counselor 5890134670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians

Practice addresses (Care Compare)

1950 Ephriham Ave
Fort Worth, TX 76164-6670
Phone (817) 813-7075

2928 N Belt Line Rd
Irving, TX 75062-5247
Phone (214) 307-7786

4115 E Lancaster Ave
Fort Worth, TX 76103-3614
Phone (817) 796-7370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Texas, PLLC CurrentSince Apr 29, 2024 Accepting new patients

Locations

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

2928 N Belt Line Rd
Irving, TX 75062
Phone (214) 307-7786

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1578155198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10818 STONE CANYON RD APT 3215",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306213",
            "telephone_number": "214-404-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 N BELT LINE RD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625247",
            "telephone_number": "214-307-7786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10818 Stone Canyon Rd Apt 3215",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752306213",
            "country_code": "US",
            "telephone_number": "214-404-5055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 N Buckner Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752183591",
            "country_code": "US",
            "telephone_number": "214-404-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MARKELSE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.