Venetia T Jordan, MS, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC012422 Issued in GA

Practice address

678 Tom Brewer Rd
Loganville, GA 30052-4005

Phone

(770) 554-3599

NPI assigned

Sep 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Venetia T Wilson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1912677535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 FANNIN DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382829",
            "telephone_number": "678-756-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 TOM BREWER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524005",
            "telephone_number": "770-554-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "VENETIA",
        "middle_name": "T",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjordan@hopehousecounseling.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "678 Tom Brewer Rd",
            "city": "Loganville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300524005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VENETIA",
            "last_name": "WILSON",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Loganville, GA
• Providers in Loganville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.