Jordan Nicole Beach

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-78117 Issued in CO

Practice address

1500 N Clybourn Ave Unit C105
Chicago, IL 60610-2295

Phone

(312) 242-1665

NPI assigned

Sep 11, 2023

Last updated

Feb 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lumiere Children's Therapy, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Chicago, IL
  • NPI 1497054050

  Behavior Analyst

  NPD
• Soar Health, Inc.

  dba Soar Autism Center

  • Behavior Analyst
  • Denver, CO
  • NPI 1437751252
  NPD (past)

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1811774037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34755 COUNTY ROAD 10",
            "city": "KEENESBURG",
            "state": "CO",
            "postal_code": "806438526",
            "telephone_number": "970-381-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N CLYBOURN AVE UNIT C105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102295",
            "telephone_number": "312-242-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-24-78117",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "A.B.61477567",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CBT.CB.61472697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Be Free Psychiatry PC
• Be Mindful Chicago Counseling, LLC
• Be Supported LLC
• Be Well Partners in Health LLC
• Joy Beach-Bachmann, NP
• John Beacom, MD
• Beacon Care and Rehabilitation Center LLC
• Beacon Care Center LLC (Beacon Care Center)
• Beacon Therapeutic
• Beacon Therapeutic School, Inc. (Beacon Therapeutic Diagnostic Treatment Center)

• Behavior Analyst in Chicago, IL
• Providers in Chicago, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.