JORDYN MATHIAS (NPI# 1538792262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538792262 |
| Entity Type | Individual |
| Full Name | JORDYN MATHIAS |
| Credential | LCPC |
| Practice Address |
102 W Kenwood Ave Ste 100 Decatur IL 62526-4379 |
| Mailing Address |
102 W Kenwood Decatur IL 62526 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175458000 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
178012446 | IL | Behavioral Health & Social Service Providers |
| Street Address |
102 W KENWOOD AVE STE 100 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275976094 | Zachary James Shipp | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2013-04-11 |
| 1043828296 | Amna Karim | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2020-07-14 |
| 1245857861 | Abhijeet S Joshi | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2020-06-30 |
| 1952925273 | Nikhil R Vatti | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2020-06-02 |
| 1295359503 | Adrine A Markosyan | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2020-06-02 |
| 1932723269 | Moomal P Shaikh | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2020-06-02 |
| 1447802681 | Jaehyeon Park | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2019-07-09 |
| 1568024867 | Samantha A Agar | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2019-07-08 |
| 1821650730 | Abhinay Walia | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2019-07-01 |
| 1225699671 | Benjamin Ford | Family Medicine | 102 W Kenwood Ave Ste 100, Decatur, IL 62526-4379 | 2019-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
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|---|---|---|---|---|
| 1598363392 | Kimberly Swanson | Counselor | 311 West Hill Street, Decatur, GA 30030-4319 | 2020-10-14 |
| 1083228050 | Lasonja D Carter | Counselor | 2920 Frost Dr Sw, Decatur, AL 35603-4531 | 2020-09-07 |
| 1154935468 | Nick Hersey | Counselor | 1924 Clairmont Rd Ste 50, Decatur, GA 30033-3450 | 2020-09-03 |
| 1760095814 | Potters Touch Counseling Inc. | Counselor | 4150 Snapfinger Woods Dr Ste 100, Decatur, GA 30035-3417 | 2020-08-28 |
| 1407464563 | Starre Cannon | Counselor | 3183 Tarian Way, Decatur, GA 30034-5539 | 2020-07-15 |
| 1164040713 | Bethany Cecelia Merrett | Counselor | 223 Kathryn Ave, Decatur, GA 30030-5017 | 2020-07-09 |
| 1053939090 | Virtue Speaks LLC | Counselor | 4150 Snapfinger Woods Dr Ste 104d, Decatur, GA 30035-3417 | 2020-07-07 |
| 1821619842 | Knitikia Gross | Counselor | 436 Eastwyck Cir, Decatur, GA 30032-6694 | 2020-04-30 |
| 1063033074 | Marcy Renee Jefferson-watkins | Counselor | 2126 6th Ave Se Ste 208, Decatur, AL 35601-6547 | 2020-04-30 |
| 1790304004 | Tonia D Morris | Counselor | 3006 Western Sunset Ct, Decatur, GA 30034-1692 | 2020-04-16 |
| Find all providers in DECATUR | ||||
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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.