Active NPI
Katherine Jordan
- Mental Health Counselor
- Walpole, MA
National Provider Identifier
1801314463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12307-MH-CC
- Practice address
- 399 Lincoln Rd
Walpole, MA 02081-1218 - Phone
- (508) 734-1852
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 12307-MH-CC | MA | Primary |
Addresses
Primary practice location
399 Lincoln Rd
Walpole, MA 02081-1218
Mailing address
399 Lincoln Rd
Walpole, MA 02081-1218
Phone (508) 734-1852
Other practice location 1
30 Warren St
Boston, MA 02135
Phone (617) 254-3800 ext. 1252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12307-MH-CC | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1801314463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 LINCOLN RD",
"city": "WALPOLE",
"state": "MA",
"postal_code": "020811218",
"telephone_number": "508-734-1852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 LINCOLN RD",
"city": "WALPOLE",
"state": "MA",
"postal_code": "020811218",
"telephone_number": "508-734-1852"
}
],
"practiceLocations": [
{
"address_1": "30 Warren St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "02135",
"country_code": "US",
"telephone_number": "617-254-3800 x1252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORDAN",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "12307-MH-CC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walpole, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.