Jordan Michael Edmondson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

66241 Issued in TX

Practice address

4228 N Central Expy Ste 225
Dallas, TX 75206-6548

Phone

(214) 763-8584

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jordan M Edmondson

  • Community/Behavioral Health Agency
  • Forney, TX
  • NPI 1558825174
  NPD

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1679044812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 FAIRMOUNT ST APT 6202",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752191119",
            "telephone_number": "214-763-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 N CENTRAL EXPY STE 225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066548",
            "telephone_number": "214-763-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "66241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oghomwen Edionwe
• Derron Edison
• John Charles Edlin, M.D.
• Laurie Edmiston, M.D.
• Joshuana Edmond
• Lindsey Edmondson, MSN, APRN, AGACNP-BC
• Robert E Edmonson, MD
• Lida Lacy Edmundson, MD
• Philip Marshall Edmundson, M.D.
• Brett Ednie, D.C.

• Mental Health Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.