JOURDAN CARLSON, Student — NPI 1700764974 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1700764974

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

101YM0800X (CMS E2)

Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor

Box 32 Service Location & ZIP+4

104 CRESTVIEW DR UNIT 104, BIGFORK, MT, 59911-3559

✓ 9-Digit EDI 837 ZIP+4 (59911-3559)

Practice Phone & Referral Fax

(106) 393-8083

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1700764974 (JOURDAN CARLSON, Student) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1700764974` (NPI-1 Individual Practitioner)
Provider / Legal Name	JOURDAN CARLSON, Student
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: `101YM0800X` (Counselor, Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	104 CRESTVIEW DR UNIT 104, BIGFORK, MT, 59911-3559
Practice Telephone / Fax	Tel: (106) 393-8083
Administrative Mailing Address	439 GRAND DR # 142, BIGFORK, MT, 59911-3614
Enumeration & Last Sync	Enumerated: 2025-08-25 \| CMS Record Updated: 2026-01-30

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

104 CRESTVIEW DR UNIT 104, BIGFORK, MT, 59911-3559

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Plain-English Taxonomy & CMS Crosswalk (101YM0800X)

What Does Taxonomy Code 101YM0800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YM0800X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E2 (Mental Health Counselor)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Mental Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JOURDAN CARLSON, Student)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JOURDAN CARLSON, Student (NPI #1700764974)