NPIMap

Organization Active NPI

Jodi Province Counseling Services PLLC

  • Professional Counselor
  • Yadkinville, NC
National Provider Identifier
1790249969
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
JODI PROVINCE COUNSELING SERVICES PLLC
Practice address
714 Carolina Ave Ste a
Yadkinville, NC 27055-7760
Phone
(336) 818-0733
Fax
(336) 818-0734
NPI assigned
Jan 22, 2019
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Jodi Tilley Province, LPCSNPI 1972638534
Title
Owner
Phone
(336) 818-0733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

714 Carolina Ave Ste a
Yadkinville, NC 27055-7760

Mailing address

1260 College Ave Ste 1
Wilkesboro, NC 28697-2700
Phone (336) 818-0733

National Provider Directory

National Provider Directory
Tax ID family
Jodi Province Counseling Services PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1260 College Ave
Ste 1
Wilkesboro, NC 28697
Phone (336) 667-5111

714 Carolina Ave
Ste A
Yadkinville, NC 27055
Phone 3368180733 ext. 101

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1790249969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 COLLEGE AVE STE 1",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972700",
            "telephone_number": "336-818-0733",
            "fax_number": "336-818-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 CAROLINA AVE STE A",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270557760",
            "telephone_number": "336-818-0733",
            "fax_number": "336-818-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI PROVINCE COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "PROVINCE",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "TILLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-818-0733",
        "authorized_official_credential": "LPCS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yadkinville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.