JORDAN B KILLPACK MC LPC CMHC NPI 1194760363

NPI Information

NPI: 1194760363
Provider Name: JORDAN B KILLPACK, MC, LPC, CMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2650 W 2700 S
SYRACUSE, UT
ZIP 84075
Phone: (956) 639-6309
Get Directions

Jordan B Killpack, MC, LPC, CMHC is a mental health counselor in Syracuse, UT. Jordan B Killpack, MC, LPC, CMHC NPI is 1194760363. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2650 W 2700 S
SYRACUSE, UT
ZIP 84075-013
Phone: (956) 639-6309
Fax: (956) 639-6309

The enumeration date for this NPI number is 6/19/2006 and was last updated on 7/21/2022.

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
1	101Y00000X	Counselor		5422738-6004	UTAH	No
2	101Y00000X	Counselor		20280	TEXAS	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	5422738-6004	UTAH	No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	20280	TEXAS	No
5	101YM0800X	Counselor	Mental Health	5422738-6004	UTAH	No
6	101YP2500X	Counselor	Professional	5422738-6004	UTAH	No
7	101YP2500X	Counselor	Professional	20280	TEXAS	No
8	101YM0800X	Counselor	Mental Health	20280	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7489LC	OTHER	TEXAS	BCBS

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »