Ketrina Lynn Jordan, EDD

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

204 Alabama Ave SW
Fort Payne, AL 35967-1953

Phone

(256) 979-1777

NPI assigned

Aug 9, 2021

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

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.

• Limestone Behavioral Health Services, Inc

  • Professional Counselor
  • Fort Payne, AL
  • NPI 1023630134
  NPD

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1508530908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 ALABAMA AVE SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671953",
            "telephone_number": "256-979-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ALABAMA AVE SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671953",
            "telephone_number": "256-979-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KETRINA",
        "middle_name": "LYNN",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Jackson
• Brilee Johnson
• Chloe Johnson, MSW
• Emily S Jones
• Marja Lee Jones, CRNP
• Luiz Juan, CRNP
• K-VA-T Food Stores Inc
• Kelseys Pharmacy Inc
• Kelli Kidd, MS,CCC-SLP
• Kidemics, LLC

• Counselor in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.