Look up the most recent NPI and PECOS records

Jordan Smith

Counselor

Behavioral Health & Social Service Providers

5420 W Sahara Ave Ste 101, Las Vegas, NV 89146-0389

PECOS Enrollment

Based on the most recent information from CMS, provider Jordan Smith does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1568914240
Provider Type
Individual
Full Name
Smith, Jordan
Gender
Female

Sole Proprietor
Yes
Enumeration Date
10/28/2016
Last Updated
2/15/2017

Contact Information

Practice Location

5420 W Sahara Ave Ste 101, Las Vegas, NV 89146-0389

(702) 882-7827

Unlisted Fax

Mailing Location

6297 Peach Orchard Rd, Las Vegas, NV 89142-0990

(209) 207-1850

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 225400000X	Description Medicaid	Issuer Unlisted Nevada

Jordan Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Giacose, Lana

Turner, Kathryn

Glasper-Johnson, Stephanie Annette

Romo, Leeza L

Gonzales, Vincent Tong

Kuo-Rice, Yi-Ling Linda

Foster, Melissa Lynn

Fulmore, Ashanta

Counseling And Neuro Dynamics Llc

Caristi, Hailey