Individual provider Active NPI

La'Kisha Jordan, LPC

  • Professional Counselor
  • Newport News, VA
National Provider Identifier
1134691900
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701007728 Issued in VA
Practice address
732 Thimble Shoals Blvd Ste 701
Newport News, VA 23606-4256
Phone
(757) 768-7528
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 0701007728 VA Primary

Addresses

Primary practice location

732 Thimble Shoals Blvd Ste 701
Newport News, VA 23606-4256

Mailing address

PO Box 2214
Newport News, VA 23609-0214
Phone (757) 768-7528

Other names 1

  • La'Kisha Jordan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701007728VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
G-R-O-W-T-H Professional CurrentSince Dec 29, 2024 Accepting new patients
Soul Therapy LLC Professional Current Accepting new patients

Locations

13195 Warwick Blvd
Ste 2E
Newport News, VA 23602
Phone (757) 214-2372

732 Thimble Shoals Blvd
Ste 701
Newport News, VA 23606
Phone (757) 633-1243

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1134691900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2214",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236090214",
            "telephone_number": "757-768-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 THIMBLE SHOALS BLVD STE 701",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064256",
            "telephone_number": "757-768-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LA'KISHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LA'KISHA",
            "last_name": "JORDAN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.