Fatima Jordan, LPC, CRC, LCASA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A10358 Issued in NC

Practice address

2309 W Cone Blvd Ste 218
Greensboro, NC 27408-4047

Phone

(336) 410-4161

NPI assigned

Aug 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Balance & Vitality, PLLC

  • Mental Health Counselor
  • Greensboro, NC
  • NPI 1750868071

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1821407073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD STE 218",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084047",
            "telephone_number": "336-410-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD STE 218",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084047",
            "telephone_number": "336-410-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "FATIMA",
        "credential": "LPC, CRC, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "22225",
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NC",
            "license": "00117659",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A10358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Healthcare and Services
• Jordan HGH LLC
• Jordan HGH LLC
• Alicia Nicole Jordan, PHARMD
• Amy Young Jordan, M.D.
• Jesse James Ray Jordan, PA-C
• Kaylin Jordan
• Megan Duffany Jordan, LCMHCS
• Melissa Jordan, LPN
• Peter Manning Jordan, M.D.

• All providers in Greensboro, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.