Individual provider Active NPI

Jordan Leanne Bergdall

  • Mental Health Counselor
  • Enid, OK
National Provider Identifier
1801705371
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
230 W Maple Ave
Enid, OK 73701-4012
Phone
(580) 478-3659
NPI assigned
Sep 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OK Primary

Addresses

Primary practice location

230 W Maple Ave
Enid, OK 73701-4012

Mailing address

507 S Garfield St
Enid, OK 73703-5512
Phone (580) 478-3659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1801705371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S GARFIELD ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035512",
            "telephone_number": "580-478-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W MAPLE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014012",
            "telephone_number": "580-478-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGDALL",
        "first_name": "JORDAN",
        "middle_name": "LEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.