Jordan Timmons, LPCC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2388 University Ave W Ste 202
Saint Paul, MN 55114-1769

Phone

(612) 492-1624

Fax

(651) 300-2702

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Practice roles

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.

• Waxing Crescent Counseling, LLC

  • Mental Health Counselor
  • St Johnsbury, VT
  • NPI 1205541133
  Medicare reassignment NPD Authorized official
• Care Clinics, LLC

  • Psychologist
  • St Louis Park, MN
  • NPI 1851716245
  NPD (past)

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1821647546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 UNIVERSITY AVE W STE 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141769",
            "telephone_number": "612-492-1624",
            "fax_number": "651-300-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 UNIVERSITY AVE W STE 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141769",
            "telephone_number": "612-492-1624",
            "fax_number": "651-300-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "JORDAN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liudmila Petrovna Timm, LPCC
• Michael R Timm, PAC
• Sydney Sarah Timm
• Kandee Kubat Timmerman, LICSW
• Richard C Timming, MD
• Delphine Nayah-Chuo Timti, NP
• Tara Jean Tindall, PHARMD
• Lisa Michelle Tindell, RN
• Heather Tinsley, RN
• Amitabh A Tipnis, MD

• Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.