Active NPI
Jordan Faith Phillips, LPC
- Counselor
- Waynesboro, VA
National Provider Identifier
1790526630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0701012465
- Practice address
- 629 Western Rd
Waynesboro, VA 22980-5626 - Phone
- (540) 292-5512
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0701012465 | VA | Primary |
Addresses
Primary practice location
629 Western Rd
Waynesboro, VA 22980-5626
Mailing address
629 Western Rd
Waynesboro, VA 22980-5626
Phone (540) 292-5512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701012465 | VA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1790526630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 WESTERN RD",
"city": "WAYNESBORO",
"state": "VA",
"postal_code": "229805626",
"telephone_number": "540-292-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 WESTERN RD",
"city": "WAYNESBORO",
"state": "VA",
"postal_code": "229805626",
"telephone_number": "540-292-5512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JORDAN",
"middle_name": "FAITH",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VA",
"license": "0701012465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesboro, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.