Active NPI
Jason Terry Jordan, LPC
- Mental Health Counselor
- Greenville, TX
National Provider Identifier
1912918293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13295
- Practice address
- 2611 Lee St
Greenville, TX 75401-4247 - Phone
- (903) 454-6334
- Fax
- (903) 454-1153
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13295 | TX | Primary |
Addresses
Primary practice location
2611 Lee St
Greenville, TX 75401-4247
Mailing address
2611 Lee St
Greenville, TX 75401-4247
Phone (903) 454-6334
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128064 | Other | TX | VALUE OPTIONS |
| 6565LC | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13295 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912918293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 LEE ST",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754014247",
"telephone_number": "903-454-6334",
"fax_number": "903-454-1153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 LEE ST",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754014247",
"telephone_number": "903-454-6334",
"fax_number": "903-454-1153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JASON",
"middle_name": "TERRY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "13295",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "128064",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "6565LC",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.