Jorden Anne Elliott-Mixon, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701008116 Issued in VA

Practice address

312 Browns Hill CT
Midlothian, VA 23114-9511

Phone

(804) 893-5555

Fax

(804) 893-5553

NPI assigned

Apr 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jorden Anne Elliott Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dougan and Walden Wellness PLLCGroup PAC ID 7012345267, 9 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.

• Dougan and Walden Wellness, PLLC

  • Psychologist
  • Midlothian, VA
  • NPI 1396259602
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1407319825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 BROWNS HILL CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149511",
            "telephone_number": "804-893-5555",
            "fax_number": "804-893-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 BROWNS HILL CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149511",
            "telephone_number": "804-893-5555",
            "fax_number": "804-893-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT-MIXON",
        "first_name": "JORDEN",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDEN",
            "last_name": "ELLIOTT",
            "middle_name": "ANNE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.