Jordan E Haire

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60728422 Issued in WA

Practice address

100 Wellness Way
410
Neah Bay, WA 98357-9835

Phone

(360) 645-3010

Fax

(360) 645-3343

NPI assigned

Dec 22, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in OH

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

Medicare enrollment (NPD)

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.

• Sirona Mental Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Chester, OH
  • NPI 1437840808
  Medicare reassignment NPD

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1780129064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 N YELLOW SPRINGS ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042463",
            "telephone_number": "937-399-9500",
            "fax_number": "937-342-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "address_2": "410",
            "city": "NEAH BAY",
            "state": "WA",
            "postal_code": "983579835",
            "telephone_number": "360-645-3010",
            "fax_number": "360-645-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRE",
        "first_name": "JORDAN",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1200640",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60728422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan S Druge, MA, PARAMEDIC
• Lawrence Stephen Eastburn, MD
• Jimmy K Elison, DMD
• David M Goldstein, RN
• Hazel Ruth Greene
• Seon Nancy Hwang, PHARMD
• Victoria Ann Jimmicum
• Johannan Elizabeth Kelly, RN
• Gordon D Kirkland, RPH
• Jessica M Latourelle, PHARMD

• Mental Health Counselor in Neah Bay, WA
• Providers in Neah Bay, 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 Dec 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.