Jordan Rae Whitley, MHS, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A20453 Issued in NC

Practice address

314 Winston Rd
Jonesville, NC 28642-2214

Phone

(336) 818-0733

Fax

(336) 571-1012

NPI assigned

Oct 9, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.whitley@direct.jpcs.nchie.net

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.

• Jodi Province Counseling Services PLLC

  • Mental Health Counselor
  • Wilkesboro, NC
  • NPI 1194050435
  NPD

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1285453852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 YALE ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286599315",
            "telephone_number": "336-452-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 WINSTON RD",
            "city": "JONESVILLE",
            "state": "NC",
            "postal_code": "286422214",
            "telephone_number": "336-818-0733",
            "fax_number": "336-571-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "JORDAN",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "MHS, LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela G. Waddell, CPT
• Mark Anthony Waddell, LPCA
• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Family Medicine - Jonesville)
• Wake Forest Health Network LLC (Tri-County Orthopedic and Sports Medicine)
• Gregory Walker, CADC MSW
• WRMC Hospital Operating Corporation (Atrium Health at Home Yadkin Valley)

• Mental Health Counselor in Jonesville, NC
• Providers in Jonesville, NC by specialty
• Mental Health Counselor in North Carolina

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