Individual provider Active NPI

Nicholas Brewer Jordan, MA, LPC

  • Professional Counselor
  • Kansas City, MO
National Provider Identifier
1720667538
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2020005149 Issued in MO
Practice address
6615 Flora Ave
Kansas City, MO 64131-1409
Phone
(816) 514-1087
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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 2020005149 MO Primary

Addresses

Primary practice location

6615 Flora Ave
Kansas City, MO 64131-1409

Mailing address

616 E 63Rd St Ste 200a
Kansas City, MO 64110-3371
Phone (816) 514-1087

Other practice location 1

616 E 63rd St Ste 200A
Kansas City, MO 64110-3371
Phone (816) 514-1087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240208004013 MO Practitioner - Mental Health Counselor 4981047610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6615 Flora Ave
Kansas City, MO 64131-1409
Phone (816) 514-1087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Njordancounseling CurrentSince Jan 1, 2024 Accepting new patients

Locations

616 E 63rd St
Ste 200A
Kansas City, MO 64110
Phone (816) 514-1087

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1720667538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E 63RD ST STE 200A",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103371",
            "telephone_number": "816-514-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 FLORA AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311409",
            "telephone_number": "816-514-1087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 E 63rd St Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641103371",
            "country_code": "US",
            "telephone_number": "816-514-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "NICHOLAS",
        "middle_name": "BREWER",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020005149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.