Active NPI
Lindsay Ann-Sisco Jordan, M.ED, ATR, LCMHC
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1235616228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 14941
- Practice address
- 3410 Healy Dr Ste 204
Winston Salem, NC 27103-1568 - Phone
- (336) 815-5570
- Fax
- (888) 253-5636
- NPI assigned
- Jul 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 14941 | NC | Primary |
Addresses
Primary practice location
3410 Healy Dr Ste 204
Winston Salem, NC 27103-1568
Mailing address
3030 Konnoak Dr
Winston Salem, NC 27127-4831
Phone (336) 963-9293
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14941 | Other | NC | LCMHC |
Other names 1
- Miss Lindsay Ann Sisco
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
| License | State | Type | Specialty |
|---|---|---|---|
| A14941 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jodi Province Counseling Services PLLC | Professional | Past | Accepting new patients |
| Jodi Province Counseling Services PLLC | Professional | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Wilkesboro, NC
- NPI 1194050435
Professional
-
- Professional Counselor
- Yadkinville, NC
- NPI 1790249969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1235616228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 KONNOAK DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271274831",
"telephone_number": "336-963-9293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3410 HEALY DR STE 204",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031568",
"telephone_number": "336-815-5570",
"fax_number": "888-253-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "LINDSAY",
"middle_name": "ANN-SISCO",
"name_prefix": "Mrs.",
"credential": "M.ED, ATR, LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-23",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "14941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCMHC",
"identifier": "14941",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LINDSAY",
"last_name": "SISCO",
"middle_name": "ANN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.