Ebony Bionica Jordan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2206016 Issued in AR

Practice address

2904 Arkansas Blvd
Texarkana, AR 71854-2536

Phone

(870) 773-4655

Fax

(870) 772-4650

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwest Arkansas Counseling and Mental Health Center, Inc 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Texarkana, AR
  • NPI 1598761553

  AR

  Medicare reassignment Care Compare group NPD
• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Hope, AR
  • NPI 1295985208
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1235565714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542536",
            "telephone_number": "870-773-4655",
            "fax_number": "870-772-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542536",
            "telephone_number": "870-773-4655",
            "fax_number": "870-772-4650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E 20th St",
            "address_purpose": "LOCATION",
            "city": "Hope",
            "state": "AR",
            "postal_code": "718018217",
            "country_code": "US",
            "telephone_number": "870-777-9051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EBONY",
        "middle_name": "BIONICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2206016",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A1906081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latishua S Jones, RN
• Melody Ann Jones, QBHP
• Vickie Lou Jones, NURSE PRACTITIONER
• Wanda Joyce Jones
• Jordan Home Health Care, LLC
• Lady Katherine Otoc Joslin, RN
• Kah Development 4, LLC
• Andrea Kelley, LMSW
• Brandon M Kelley
• Chireta D Kelley

• All providers in Texarkana, AR
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.

Verify at the official NPI Registry.