Jordan Coles, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1132 28TH Ave S Ste 102
Moorhead, MN 56560-4420

Phone

(218) 512-0630

Fax

(218) 512-0437

NPI assigned

Jun 17, 2013

Sex

Male

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 MN

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

SLV Group LLCGroup PAC ID 2466821251, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• SLV Group, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Moorhead, MN
  • NPI 1285352872

  Mental Health, MN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1902245665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 102",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "218-512-0630",
            "fax_number": "218-329-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 102",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "218-512-0630",
            "fax_number": "218-512-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLES",
        "first_name": "JORDAN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay County Social Services
• Clay Moorhead Holdings LLC
• Coborns Inc
• Elizabeth Cogan
• Aaron Coleman, LPC
• Collective Home Care Services LLP
• Rebeccah Collett
• Lukas Collins
• Laurene Collison
• Comfort Care Angels LLC

• All providers in Moorhead, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.