Active NPI
Jordan Kennedy, LPC
- Professional Counselor
- Salem, VA
National Provider Identifier
1225852957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701014039
- Practice address
- 1932 Braeburn Dr
Salem, VA 24153-7302 - Phone
- (540) 529-8543
- Fax
- (540) 378-6044
- NPI assigned
- Nov 11, 2024
- Last updated
- Nov 11, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701014039 | VA | Primary |
Addresses
Primary practice location
1932 Braeburn Dr
Salem, VA 24153-7302
Mailing address
1932 Braeburn Dr
Salem, VA 24153-7302
Phone (540) 529-8543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5303 A Indian Grave Rd
Roanoke, VA 24018-9107
Phone (540) 238-7675
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701014039 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enjoy Counseling Services LLC | Current | Accepting new patients |
Locations
1932 Braeburn Dr
Salem, VA 24153
Phone (540) 529-8543
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counselor
- Salem, VA
- NPI 1528731429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1225852957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1932 BRAEBURN DR",
"city": "SALEM",
"state": "VA",
"postal_code": "241537302",
"telephone_number": "540-529-8543",
"fax_number": "540-378-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1932 BRAEBURN DR",
"city": "SALEM",
"state": "VA",
"postal_code": "241537302",
"telephone_number": "540-529-8543",
"fax_number": "540-378-6044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JORDAN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-11",
"last_updated": "2024-11-11",
"certification_date": "2024-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701014039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.