Jordan Anderson Royals, LPC, NCC, CMHT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2642 Issued in MS

Practice address

6880 Cobblestone Blvd Ste 1
Southaven, MS 38672-9313

Phone

(622) 253-8324

NPI assigned

Feb 20, 2020

Last updated

Sep 1, 2022By 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 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desoto Family Wellness Center, LLC

  • Multi-Specialty Clinic/Center
  • Southaven, MS
  • NPI 1376143024

  Professional

  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1841823515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6880 COBBLESTONE BLVD STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729313",
            "telephone_number": "622-253-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6880 COBBLESTONE BLVD STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729313",
            "telephone_number": "622-253-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYALS",
        "first_name": "JORDAN",
        "middle_name": "ANDERSON",
        "credential": "LPC, NCC, CMHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1516",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rome Sherrod II MD
• Scott Stuart Rosen, MD
• Chad Montgomery Ross, MD
• Rodney D. Rothstein, MD
• Kyle Routh, LPC
• Nathan Rucker, PHARMD
• Spencer Rushing, DO
• Jason Russell
• Kaitlin Alexander Ryan, DPT
• Robert Lawrence Ryan, CRNA

• Professional Counselor in Southaven, MS
• Providers in Southaven, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.