712 Q.a.C.C. Counseling for the Soul

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

712 Q.A.C.C. COUNSELING FOR THE SOUL

Practice address

13051 Abercorn St Ste B3 526
Savannah, GA 31419-3141

Phone

(678) 744-5603

Fax

(877) 278-1045

NPI assigned

Mar 3, 2020

Last updated

Mar 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrina Jordan, LPC, NCCNPI 1245625920

Title

Founder/Ceo

Phone

(678) 744-5603

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrina Jordan, LPC

  • Professional Counselor
  • Paw Paw, MI
  • NPI 1245625920
  NPD Authorized official

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1922633692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7174",
            "city": "GARDEN CITY",
            "state": "GA",
            "postal_code": "314187174",
            "telephone_number": "678-744-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13051 ABERCORN ST STE B3 526",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314193141",
            "telephone_number": "678-744-5603",
            "fax_number": "877-278-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "712 Q.A.C.C. COUNSELING FOR THE SOUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "ANDRINA",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "678-744-5603",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.