Killpack, Jordan B
Killpack, Jordan B is an individual health care provider with primary practice located at 2650 W 2700 S , Syracuse UT 84075-9013. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Killpack, Jordan B can be contacted via phone (956) 639-6309.Contact Information
Primary practice address
2650 W 2700 S
Syracuse UT 84075-9013
Phone: (956) 639-6309
Fax: (956) 639-6309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 5422738-6004 | Utah |
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 20280 | Texas |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 5422738-6004 | Utah |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 20280 | Texas |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 5422738-6004 | Utah |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 5422738-6004 | Utah |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 20280 | Texas |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 20280 | Texas |
Profile Details
| NPI number | 1194760363 |
|---|---|
| LBN Legal business name | Killpack, Jordan B |
| Credentials | MC, LPC, CMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194760363 | NPPES |
| Texas | Other | 7489LC | BCBS |
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