Tiffany Jordan, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180.009045 Issued in IL

Practice address

6615 N Big Hollow Rd
Peoria, IL 61615

Phone

(309) 692-6622

Fax

(309) 692-6952

NPI assigned

Mar 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Antioch Group, Inc.

  • Psychologist
  • Peoria, IL
  • NPI 1801993142
  NPD (past)

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1154748747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152450",
            "telephone_number": "309-692-6622",
            "fax_number": "309-692-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-692-6622",
            "fax_number": "309-692-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TIFFANY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009045",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.009045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise M Joos, APN
• Melissa J Joos, RN
• Keli Elizabeth Jordan-Gardner, OD
• John Michael Jordan, R.PH., PH. D.
• Kimberly Jordan, PT
• Joseph & Hishon Integrated Health Center LTD
• Joseph M. Pope D.D.S.,LTD.
• Daniel Todd Joseph, DC
• Jermin Joseph, DMD
• Rachel Joseph, PHARMD

• Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.