Jordan Wixom, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-7628 Issued in ID

Practice address

2267 Teton PLZ
Idaho Falls, ID 83404-6486

Phone

(208) 522-0140

NPI assigned

Aug 8, 2017

Sex

Female

Sole proprietor

Yes

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

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Human Dynamics and Diagnostics, LLC

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
  • NPI 1346368198
  NPD

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1982129177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-522-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-522-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXOM",
        "first_name": "JORDAN",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-7628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brady Matthew Wirick, D,C,
• Shane Oliver Withers Jr., PHARMD, BCPS
• Wixom Counseling Inc
• Wixom Counseling Online
• Bret V. Wixom, LCSW
• Zachary Wixom, LMSW
• Women'S Healthcare Associates
• Women'S Healthcare Associates, P.a.
• Jerrilynne Wood, LCPC-4457
• Kaydee Wood

• Mental Health Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.