Individual provider Active NPI

Adele Andrea Jordan, LCMHCA

  • Professional Counselor
  • Huntersville, NC
National Provider Identifier
1912469057
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A13627 Issued in NC
Practice address
400 Gilead Rd Unit 1546
Huntersville, NC 28070-6866
Phone
(704) 896-6044
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A13627 NC Primary

Addresses

Primary practice location

400 Gilead Rd Unit 1546
Huntersville, NC 28070-6866

Mailing address

8924 Raven Top Dr
Mint Hill, NC 28227-3617
Phone (301) 325-4158

Other names 1

  • Adele Andrea Thorpe Former name

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

LicenseStateTypeSpecialty
A13627NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Graced 4 Healing Counseling, PLLC Current Accepting new patients
Integrated Holistic Solutions, PLLC Professional CurrentSince Dec 27, 2020 Accepting new patients

Locations

400 Gilead Rd
Unit 1546
Huntersville, NC 28070
Phone (704) 896-6044

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1912469057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8924 RAVEN TOP DR",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282273617",
            "telephone_number": "301-325-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GILEAD RD UNIT 1546",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280706866",
            "telephone_number": "704-896-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ADELE",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADELE",
            "last_name": "THORPE",
            "middle_name": "ANDREA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.