Individual provider Active NPI

Jordan Taylor Dickens, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1831818822
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1088701 Issued in TX
Practice address
3355 W Alabama St Ste 195
Houston, TX 77098-1871
Phone
(844) 824-8775
Fax
(281) 648-2200
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1088701 TX Primary

Addresses

Primary practice location

3355 W Alabama St Ste 195
Houston, TX 77098-1871

Mailing address

3355 W Alabama St Ste 195
Houston, TX 77098-1871
Phone (844) 824-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807001552 TX Practitioner - Nurse Practitioner 2466813480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

3355 W Alabama St
Suite 195
Houston, TX 77098-1871
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Psychiatric/Mental Health CurrentSince Jul 7, 2023 Accepting new patients

Locations

308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

3355 W Alabama St
Ste 195
Houston, TX 77098
Phone (832) 895-6255

4242 Medical Dr
Ste 6300
San Antonio, TX 78229
Phone (210) 614-8400

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jordandickens@136732.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1831818822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 W ALABAMA ST STE 195",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981871",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 W ALABAMA ST STE 195",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981871",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "JORDAN",
        "middle_name": "TAYLOR",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1088701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.