Jordan Deacon Humphreys, M.A.ED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701012699 Issued in VA

Practice address

241 Greenhouse Rd
Lexington, VA 24450-3717

Phone

(540) 463-3141

Fax

(540) 462-6705

NPI assigned

Jul 26, 2023

Last updated

Jul 26, 2023By the provider in NPPES

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

Other names 1

• Jordan Nicole Deacon 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rockbridge Area Community Services Board

  • Community/Behavioral Health Agency
  • Lexington, VA
  • NPI 1649377912
  Medicare reassignment NPD

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1679254312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 GREENHOUSE RD",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244503717",
            "telephone_number": "540-463-3141",
            "fax_number": "540-462-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 GREENHOUSE RD",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244503717",
            "telephone_number": "540-463-3141",
            "fax_number": "540-462-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "JORDAN",
        "middle_name": "DEACON",
        "credential": "M.A.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701012699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "DEACON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane Tracy Horton, MD
• Marc A Hudson, OD
• Bobbie Huffman
• Richard Raymond Hull, DMD
• Robert C. Hull, D.D.S.
• Michael Huntsman, CRNA
• Robert P Irons Jr., MD
• Heidi Sherman Jay, D.D.S.
• Julie Adams Jennings, PH. D.
• Lacee Simmons Jeter

• Mental Health Counselor in Lexington, VA
• Providers in Lexington, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.