Jordan Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61303990 Issued in WA

Practice address

2110 Iron St
Bellingham, WA 98225-4123

Phone

(360) 930-6063

NPI assigned

Jul 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1699127969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13019 HAAS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902491712",
            "telephone_number": "310-701-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 IRON ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254123",
            "telephone_number": "360-930-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60676407",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61303990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J,K, & L, Inc.
• Shafaq Jabeen, MD
• Frances Jablonski, MD
• Teresa Jackson-Novak, MD
• Jacob Nathaniel Jackson
• Karen Jackson, M.A., LMFT
• Kinsey Jackson
• Stacey Marie Jackson, PTA
• Taylor Mae Jackson, CDPT
• Allison Joy Jacobs, DDS

• Mental Health Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.