TYNETTE JORDAN (NPI# 1124439351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124439351 |
| Entity Type | Individual |
| Full Name | TYNETTE JORDAN |
| Practice Address |
708 N.w Wilson St. Lake City FL 32055 |
| Mailing Address |
708 Nw Wilson St Lake City FL 32055-1808 |
| Practice Telephone | 4076808483 |
| Mailing Telephone | 4076808483 |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
708 N.W WILSON ST. |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1437579372 | Shara Evans | Specialist | 501 Nw Lake City Ave, Apt 103, Lake City, FL 32055 | 2014-04-18 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366171 | Neurodiverse Ability Services LLC | Counselor | 608 Sw Marvin Burnett Rd, Lake City, FL 32025-4918 | 2020-11-02 |
| 1538715016 | Vanessa George | Counselor | 930 Ne Joe Coney Ter, Lake City, FL 32055-1636 | 2019-08-12 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1811399439 | Michael Ortiz | Counselor | 311 Se Mill Creek Ct, Lake City, FL 32025-3912 | 2014-09-25 |
| 1730426347 | Jesenia Minniefield | Counselor | 136 Nw Veterans St, Lake City, FL 32055-3900 | 2013-01-16 |
| 1780957050 | Daphne O Cunningham | Counselor | 922 Sw Baya Dr, Lake City, FL 32025-4209 | 2012-02-17 |
| 1841585874 | Vadonna Benson Bartell | Counselor | 711 Bartells Rd, Lake City, SC 29560-7564 | 2011-06-17 |
| 1417100140 | Resolutions Health Alliance, P.a. | Counselor | 297 Nw Hillsboro St, Lake City, FL 32055-3320 | 2008-10-28 |
| 1093974164 | Robert Reynierson | Counselor | 439 Sw Michigan Street, Lake City, FL 32025-0440 | 2008-06-04 |
| 1326206012 | Julie Melvin | Counselor | 761 Se Defender Dr, Lake City, FL 32025-6367 | 2008-05-29 |
| Find all providers in LAKE CITY | ||||
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| 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.