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JORDAN JACKSON LPC
NPI 1154211704
Counselor in Grand Bay, AL

Active since July 07, 2025PECOS Enrolled
5153 WEAR RD APT 1, GRAND BAY, AL 36541(601) 434-0616 Get Directions Write a Review

NPPES record last updated: July 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Jackson Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN JACKSON LPC (NPI 1154211704) is an individual counselor in Grand Bay, Alabama, licensed in Mississippi (3309) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1154211704
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameJORDAN JACKSONCredential: LPC
Location Address5153 WEAR RD APT 1Grand Bay, AL 36541-3223
Mailing Address5153 Wear RdGrand Bay, AL 36541-3223 · (601) 434-0616
Phone(601) 434-0616
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 7, 2025
NPPES CertifiedJuly 7, 2025
✔ NPI 1154211704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in MS · 3309
Definition
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.
5153 WEAR RD APT 1, Grand Bay, AL 36541
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Jackson Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9436646858
PECOS Enrollment IDI20251017001017
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Jackson's NPI number?

The NPI number for Jordan Jackson is 1154211704. It was assigned to this individual provider in the NPPES registry on July 7, 2025.

Where is Jordan Jackson located?

Jordan Jackson practices at 5153 Wear Rd Apt 1, Grand Bay, AL 36541. The listed phone number is (601) 434-0616.

What is Jordan Jackson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jordan Jackson enrolled in Medicare?

Yes. Jordan Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Jackson was last updated on July 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.