MRS. KATHRYN V JORDAN


Address: 3122 Vashti Rd, Taylorsville, NC 28681-6828
Phone: 3366443510

MRS. KATHRYN V JORDAN (NPI# 1023269610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023269610
Entity Type Individual
Full Name MRS. KATHRYN V JORDAN
Credential QMHP
Practice Address 3122 Vashti Rd
Taylorsville
NC 28681-6828
Mailing Address 763 Shady Hanes Rd
Lexington
NC 27295-8604
Practice Telephone 3366443510
Mailing Telephone 3366443510
Enumeration Date 2008-10-01
Last Update Date 2008-10-01
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

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1760763940 Kathryn L Jordan Massage Therapist 2207 N Weber St, Colorado Springs, CO 80907-6946 2011-09-01
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1386628584 Kathryn J Jordan Nurse Practitioner 216 E College, Mason, TX 76856-1390 2005-12-01

Office Location

Street Address 3122 VASHTI RD
City TAYLORSVILLE
State NC
Zip Code 28681-6828

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922249374 Peace Haven Group Home, LLC Residential Treatment Facility, Emotionally Disturbed Children 3122 Vashti Rd, Taylorsville, NC 28681-6828 2009-03-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679137665 Kenzi Care LLC Assisted Living Facility 668 Wood Rd, Taylorsville, NC 28681 2019-04-25
1831651918 Rebecca Ann Soltysiak Speech-Language Pathologist 581 Hwy 16 South, Taylorsville, NC 28681 2019-04-05
1356790745 Carolina Dental Care Centere Dentist 556 Nc-16, Taylorsville, NC 28681 2016-06-07
1952738999 Changing Lives Now LLC Residential Treatment Facility, Emotionally Disturbed Children 3598 North Carolina 90, Taylorsville, NC 28681 2013-10-05
1952642472 Counseling and Support Associates, PC Community/Behavioral Health 121 E. Main Ave., Taylorsville, NC 28681 2013-03-07
1649550237 Matthew Tyler Holland Chiropractor 92 Main Ave Drive, Taylorsville, NC 28681 2011-08-26
1811147358 Sachi J Jhaveri-mehta Psychologist 630 Old Landfill Road, Taylorsville, NC 28681 2008-09-21
1033324421 Jack T. Brinkley, D.m.d., P.a. Dentist 163 Main Avenue Drive, Taylorsville, NC 28681 2007-05-11
1649303579 Comserv, Inc. Intermediate Care Facility, Mentally Retarded 4165 Nc Highway 127, Taylorsville, NC 28681 2007-03-13
1144381765 Diane Gaines Counselor 397 3rd Avenue Sw, Taylorsville, NC 28681 2006-12-13
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952738999 Changing Lives Now LLC Residential Treatment Facility, Emotionally Disturbed Children 3598 North Carolina 90, Taylorsville, NC 28681 2013-10-05
1003180233 Walkers Group Home Residential Treatment Facility, Emotionally Disturbed Children 229 7th St Sw, Taylorsville, NC 28681-2411 2012-03-06
1922249374 Peace Haven Group Home, LLC Residential Treatment Facility, Emotionally Disturbed Children 3122 Vashti Rd, Taylorsville, NC 28681-6828 2009-03-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023617255 Creative Helping Hands LLC Residential Treatment Facility, Emotionally Disturbed Children 478 Green Lake Rd, Rockingham, NC 28379-7850 2020-10-19
1083237986 Revive Housing LLC Residential Treatment Facility, Emotionally Disturbed Children 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 2020-05-26
1457998627 Re Health Group Residential Treatment Facility, Emotionally Disturbed Children 1102 Groves St, Kings Mountain, NC 28086-2232 2019-12-05
1821631532 Marquita Latrice Walls Residential Treatment Facility, Emotionally Disturbed Children 1565 Longbranch Rd, Grover, NC 28073-9599 2019-10-25
1699233866 A Brighter Path LLC Residential Treatment Facility, Emotionally Disturbed Children 120 Jetter Rd, Grover, NC 28073-9687 2019-03-06
1821562224 Carter Clinic, Pa Residential Treatment Facility, Emotionally Disturbed Children 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 2019-01-18
1659842607 Gervonia Robinson Residential Treatment Facility, Emotionally Disturbed Children 1714 Aster Ln, Gastonia, NC 28054-8303 2018-12-16
1679058440 Miracle Houses Inc Residential Treatment Facility, Emotionally Disturbed Children 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 2018-09-27
1174048078 A Safe Place Community Housing, LLC Residential Treatment Facility, Emotionally Disturbed Children 2049 Highland St, Charlotte, NC 28208-4909 2017-08-11
1104346881 Inspiration for Us Residential Treatment Facility, Emotionally Disturbed Children 1205 W Mountain St, Kernersville, NC 27284-2173 2017-06-22
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Competitor

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City TAYLORSVILLE
Zip Code 28681

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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