MR. JORDAN MICHAEL ZICKAFOOSE LMFT
NPI 1457773236
Marriage & Family Therapist in Fresno, CA

Q: What is Jordan Zickafoose's NPI number?

The NPI number for Jordan Zickafoose is 1457773236. It was assigned to this individual provider in the NPPES registry on January 13, 2014.

Q: What is Jordan Zickafoose's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Zickafoose was last updated on December 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.

Active since January 13, 2014PECOS Enrolled

6051 N FRESNO ST STE 201, FRESNO, CA 93710(559) 248-8550(559) 248-8555 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 6, 2024, Dec 17, 2019 (2 updates tracked since 2019).

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About Mr. Jordan Michael Zickafoose Lmft NPPES

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

MR. JORDAN MICHAEL ZICKAFOOSE LMFT (NPI 1457773236) is an individual marriage & family therapist in Fresno, California, licensed in California (151435) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1457773236

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameMR. JORDAN MICHAEL ZICKAFOOSECredential: LMFT

Location Address6051 N FRESNO ST STE 201Fresno, CA 93710-5280

Mailing Address6051 N Fresno St Ste 201Fresno, CA 93710-5280 · (559) 248-8550 · Fax (559) 248-8555

Phone(559) 248-8550

Fax(559) 248-8555

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateJanuary 13, 2014

Last NPPES UpdateDecember 6, 20242 updates tracked since enumeration

NPPES CertifiedDecember 6, 2024

✔ NPI 1457773236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 151435

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

6051 N FRESNO ST STE 201, Fresno, CA 93710

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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)

Mr. Jordan Michael Zickafoose Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476038001

PECOS Enrollment IDI20260331003818

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASMIN IRIRIAN LIYANAGE

Day Training/Habilitation Specialist