EBONY BIONICA JORDAN (NPI# 1235565714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235565714 |
| Entity Type | Individual |
| Full Name | EBONY BIONICA JORDAN |
| Practice Address |
1658 Us Highway 371 Prescott AR 71857-7064 |
| Mailing Address |
2904 Arkansas Blvd Texarkana AR 71854-2536 |
| Practice Telephone | 8708873660 |
| Practice Fax Number | 8708873705 |
| Mailing Telephone | 8707734655 |
| Mailing Fax Number | 8707724650 |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2019-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | A1906081 | AR | Behavioral Health & Social Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891009346 | Ebony Jordan | Dentist | 1633 N Capitol Ave, #200, Indianapolis, IN 46202-1261 | 2010-07-27 |
| Street Address |
1658 US HIGHWAY 371 |
| City | PRESCOTT |
| State | AR |
| Zip Code | 71857-7064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366495806 | Kimberly Janet Tye | Licensed Practical Nurse | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2006-05-18 |
| 1821695925 | Aubrey Walker | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2020-10-02 |
| 1194350637 | Danny Mclay Jr | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2020-03-05 |
| 1902431448 | Allegra L Deloney | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2020-03-05 |
| 1811533946 | Amari K Davis | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-11-25 |
| 1154967297 | Kayleigh White | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-11-25 |
| 1902442049 | Vonderrick Robinson | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-11-25 |
| 1871135855 | Lakeitha Rose | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-10-11 |
| 1033751011 | Jami J Block | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-10-11 |
| 1194366203 | Kendra N Copeland | Case Manager/Care Coordinator | 1658 Us Highway 371, Prescott, AR 71857-7064 | 2019-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598915514 | Southwest Arkansas Counseling and Mental Health Center, Inc | Community/Behavioral Health | 1658 Highway 371 West, Prescott, AR 71857 | 2008-09-26 |
| 1366607897 | Texarkana Behavioral Associates | Clinic/Center | 1484 West 1st Street, North, Prescott, AR 71857 | 2008-07-24 |
| 1295949238 | Pnc, Inc. | Day Training, Developmentally Disabled Services | 504 East 4th St North, Prescott, AR 71857 | 2007-05-09 |
| 1659597698 | Charles Vermont, M.d., Pllc | Family Medicine | 1480 West First North, Prescott, AR 71857 | 2007-04-18 |
| 1255464699 | Donisha Lafae Samuels | Case Manager/Care Coordinator | 1658 Hwy 371 W, Prescott, AR 71857 | 2007-03-14 |
| 1699856278 | Audie M Teague O D P A | Optometrist | 204 E 2nd Sreet S, Prescott, AR 71857 | 2006-10-18 |
| 1154411379 | Michele Rhodes | Nurse Practitioner | 1501 West First Street, Ark Department of Health and Human Services, Prescott, AR 71857 | 2006-10-16 |
| 1821185091 | Audie M. Teague | Optometrist | 204 E 2nd Street S, Prescott, AR 71857 | 2006-10-06 |
| 1760402804 | Mary Lou Kaufman | Licensed Practical Nurse | 1658 Hyw 371 West, Prescott, AR 71857 | 2006-07-20 |
| 1073532388 | Cindie Dianne Mckamie | Registered Nurse | 1658 Hwy 371 West, Prescott, AR 71857 | 2006-07-18 |
| Find all providers in zip 71857 | ||||
| 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 |
|---|---|---|---|---|
| 1124639414 | Karissa Bruce | Counselor | 141 S Mccormick St Ste 103, Prescott, AZ 86303-4730 | 2020-08-11 |
| 1205468253 | Honeybee Healing & Counseling Services, LLC | Counselor | 1490 W Gurley St Ste C, Prescott, AZ 86305-2851 | 2020-02-07 |
| 1144784364 | Kathryn Ann Stoecker | Counselor | 141 S Mccormick St Ste 214, Prescott, AZ 86303-4731 | 2019-01-23 |
| 1437659075 | Laura Solorzano | Counselor | 1612 Eagle Point Dr, Prescott, AZ 86301-5487 | 2018-02-20 |
| 1124538236 | Jon Gary Nelson | Counselor | 4992 Cactus Pl, Prescott, AZ 86301-5845 | 2017-10-03 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1912420738 | Sandra Lehmann | Counselor | 3700 Willow Creek Rd Bldg 46, Prescott, AZ 86301-3721 | 2017-07-24 |
| 1194277202 | Tracy Schrunk | Counselor | 1277 N Rhinestone Dr, Prescott, AZ 86301-6802 | 2016-10-25 |
| 1871944322 | Jessie Deverna | Counselor | 450 W Goodwin St Suite 103b, Prescott, AZ 86303 | 2016-06-27 |
| 1760838502 | Sarah Munigle | Counselor | 141 S Mccormick St Ste 206a, Prescott, AZ 86303-4749 | 2016-05-11 |
| Find all providers in PRESCOTT | ||||
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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.