JORDAN JACKSON LPC NPI 1154211704

NPI Information

  • NPI: 1154211704
  • Provider Name: JORDAN JACKSON, LPC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5153 WEAR RD APT 1
    GRAND BAY, AL
    ZIP 36541
  • Phone: (601) 434-0616

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NPI Details

Jordan Jackson, LPC is a counselor in Grand Bay, AL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Jordan Jackson, LPC NPI is 1154211704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5153 WEAR RD APT 1
GRAND BAY, AL
ZIP 36541-223
Phone: (601) 434-0616

The NPI 1154211704 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/7/2025 and was last updated on 7/7/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselor3309MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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