Audra Nicole Jalbert, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1570 E Northern Ave Ste C
Kingman, AZ 86409-2483

Phone

(928) 263-1045

NPI assigned

Jul 25, 2016

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

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.

• Mohave Neurofeedback Clinic, LLC

  dba Mohave Neurofeedback

  • Professional Counselor
  • Kingman, AZ
  • NPI 1174249015
  NPD Authorized official

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1962955161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 E NORTHERN AVE STE C",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092483",
            "telephone_number": "928-263-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALBERT",
        "first_name": "AUDRA",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008058",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0580630",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janis E Jablenski, CPHT
• Jackson Eye Center PLLC
• Kenneth Douglas Jackson, M.D.
• Todd Lincoln Jackson, M.D.
• Brian Jahnny, D.O.
• Syed Zahid Jamal, MD
• Lauren Camille Jarmie Harris, PH.D.
• Christopher Jarrell, FNP
• Jason C Allen DPM PLLC (Cornerstone Podiatry)
• Jason W Lowry DDS PLLC

• Professional Counselor in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.