Jordan Thomas Parker, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701014455 Issued in VA

Practice address

4445 Corporation LN
Virginia Beach, VA 23462-3262

Phone

(757) 233-0003

NPI assigned

Jan 28, 2025

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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.

• Your Nurse Practitioner PLLC

  dba Panacea Behavioral Health & Wellness Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1801489711
  Medicare reassignment NPD

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1851104582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 EVERGREEN CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233214209",
            "telephone_number": "757-572-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "757-233-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4360 Shore Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234552994",
            "country_code": "US",
            "telephone_number": "757-251-0879",
            "fax_number": "984-220-9437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JORDAN",
        "middle_name": "THOMAS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701014455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyeong Man Park, DDS
• Sarah Park
• Akilah Parker
• Breanna Parker
• David Allen Parker
• Kimberly Parker
• Lakisha Parker
• Lambert Titus Parker, MD
• Megan Lee Parker, MSW
• Reiley Elizabeth Parker, LPC

• Mental Health Counselor in Virginia Beach, VA
• Providers in Virginia Beach, 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 Mar 27, 2025; 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.