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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TYSHONNA DOMRAE JORDAN

Deactivated

TYSHONNA DOMRAE JORDAN is a Mental Health Counselor healthcare provider located in DINWIDDIE, Virginia. NPI 1225546153 is deactivated in the NPPES registry. Verify at CMS.

Mental Health Counselor · DINWIDDIE, VA

This NPI has been deactivated. The record was deactivated on January 30, 2018. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1225546153
Provider Type
Individual
Gender
Female
NPI Issued
Jan 12, 2018 (0.049315068493151 yrs)
Last Updated
Apr 12, 2021
Deactivated
Jan 30, 2018

Practice Information

Address
12318 BOYDTON PLANK RD.
DINWIDDIE, VA, 23841
Browse VA providers · Browse ZIP 23841
Phone
8045049089
Primary Specialty
Mental Health Counselor
101YM0800X

Other Mental Health Counselor Providers in DINWIDDIE, VA

Name Credential NPI
MRS. JAMONICA RENEE WORSHAM 1316456668
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.