MS. JACKIE D JORDAN (NPI# 1114263001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114263001 |
| Entity Type | Individual |
| Full Name | MS. JACKIE D JORDAN |
| Credential | MA, LADC |
| Practice Address |
3700 N Classen Blvd Suite C-55 Oklahoma City OK 73118-2872 |
| Practice Telephone | 4056050881 |
| Practice Fax Number | 4056050879 |
| Mailing Telephone | 4056050881 |
| Mailing Fax Number | 4056050879 |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2012-12-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
490 | OK | Behavioral Health & Social Service Providers |
| Street Address |
3700 N CLASSEN BLVD SUITE C-55 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73118-2872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134429392 | Marcus Lewis | Counselor | 3700 N Classen Blvd, Oklahoma City, OK 73118-2872 | 2010-10-21 |
| 1114558210 | Aaron L Chavers | Case Manager/Care Coordinator | 3700 N Classen Blvd, Oklahoma City, OK 73118-2872 | 2020-01-28 |
| 1255870259 | Instilling Hope & Wellness LLC | Community/Behavioral Health | 3700 N Classen Blvd, Oklahoma City, OK 73118-2872 | 2017-02-23 |
| 1215357660 | Second Wind Recovery and Support Services Pllc | Community/Behavioral Health | 3700 N Classen Blvd, Suite C-55, Oklahoma City, OK 73118-2872 | 2014-04-24 |
| 1255764510 | Willie A Sellers | Counselor | 3700 N Classen Blvd, Oklahoma City, OK 73118-2872 | 2013-08-09 |
| 1396183448 | Premier Behavioral Health & Therapeutic Services | Community/Behavioral Health | 3700 N Classen Blvd, C35, Oklahoma City, OK 73118-2872 | 2013-06-11 |
| 1861793036 | Piper L Smith | Counselor | 3700 N Classen Blvd, 240, Oklahoma City, OK 73118-2872 | 2010-11-04 |
| 1295036465 | Kenya R Freelen | Counselor | 3700 N Classen Blvd, 240, Oklahoma City, OK 73118-2872 | 2010-11-04 |
| 1902107162 | Family Recvery Counseling Center | Community/Behavioral Health | 3700 N Classen Blvd, 240, Oklahoma City, OK 73118-2872 | 2010-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255812772 | Karrie Danea Moreno | Behavior Technician | 1507 Ne 31st, Oklahoma, OK 73118 | 2018-08-23 |
| 1528578499 | Revive Medical LLC | General Practice | 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118 | 2017-10-05 |
| 1225556228 | Anika Carr | Case Manager/Care Coordinator | 1212 Nw 32nd Street, Oklahoma City, OK 73118 | 2017-08-30 |
| 1740635168 | Nikhil Malhotra | Internal Medicine | 3635 Vista Avenue At Grand Boulevard, 14th Floor, Desloge Towers, St. Louis, MO 73118 | 2016-05-04 |
| 1144694183 | Christopher Woon | Counselor | 4001 N Classen, Suite 105, Oklahoma City, OK 73118 | 2015-11-13 |
| 1699181925 | Stac Embry | Counselor | 3321 N. Mckinley Ave, Oklahoma City, OK 73118 | 2014-07-08 |
| 1194161216 | Jennifer Kaye Powers | Counselor | 3124 N. Classen Blvd., Ste. A, Oklahoma City, OK 73118 | 2013-05-15 |
| 1932445491 | Jessica Camp | Behavioral Analyst | 3220 N Harvey Pkwy, Oklahoma City, OK 73118 | 2013-01-02 |
| 1942578661 | Michael D Danielson | Behavioral Analyst | 4232 N Sante Fe Ave, Oklahoma City, OK 73118 | 2011-12-08 |
| 1912280587 | Tara Roberts | Counselor | 1743 Nw 37th, Oklahoma City, OK 73118 | 2011-09-21 |
| Find all providers in zip 73118 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1679811624 | Rashawn T Mance | Psychologist | 2609 Featherstone Rd, Apt 408, Oklahoma City, OK 73120-2105 | 2013-01-26 |
| 1598069031 | Cynthia Ann Barker | Psychologist | 3300 Nw 56th St Ste 220, Oklahoma City, OK 73112-4401 | 2010-12-24 |
| 1508425042 | Samantha Danielle Price | Psychologist | 921 Ne 13th St # 116a, Oklahoma City, OK 73104-5007 | 2019-06-09 |
| 1518458439 | Walter E Cooper | Psychologist | 1215 Nw 25th St, Oklahoma City, OK 73106-5629 | 2018-05-25 |
| 1750651386 | Monica Rizzuto Crain | Psychologist | 301 W I 240 Service Rd, Oklahoma City, OK 73139-7701 | 2012-01-12 |
| 1457509739 | Catherine Jarvis Shaw | Psychologist | 921 Ne 13th St, 116 C, Oklahoma City, OK 73104-5007 | 2008-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1245636497 | Elisabeth Pitts | Psychologist | 301 W Maine Ave, Enid, OK 73701-5673 | 2014-11-17 |
| 1013347988 | Bradford Don Holinsworth | Psychologist | 2009 S Cherokee Pl, Claremore, OK 74019-3538 | 2013-11-13 |
| 1356683387 | Darryn K Herron I | Psychologist | 5641 S 88th East Ave, Tulsa, OK 74145-7905 | 2013-03-15 |
| 1144431016 | Helen Lee Veach | Psychologist | 35962 Ew 1300, Seminole, OK 74868-5870 | 2007-05-24 |
| 1437538634 | Robert Thomas Libey | Psychologist | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2015-05-21 |
| 1255638904 | Denise M Dart | Psychologist | 2321 E 3rd St, Tulsa, OK 74104-1831 | 2011-02-16 |
| 1538495692 | Marti Leeann Nichols | Psychologist | 205 S Adair St, Pryor, OK 74361-5201 | 2009-10-26 |
| City | OKLAHOMA CITY |
| Zip Code | 73118 |
Please comment or provide details below to improve the information on MS. JACKIE D JORDAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.