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TYSHONNA DOMRAE JORDAN
NPI 1225546153
Counselor - Mental Health in Dinwiddie, VA

Active since January 12, 2018
12318 BOYDTON PLANK RD., DINWIDDIE, VA 23841(804) 504-9089 Get Directions Write a Review

NPPES record last updated: April 12, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 12, 2021, Jan 12, 2018 (2 updates tracked since 2018).

About Tyshonna Domrae Jordan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYSHONNA DOMRAE JORDAN (NPI 1225546153) is an individual mental health provider in Dinwiddie, Virginia and active in the NPI registry since January 2018.

NPPES Registry Identity

NPI1225546153
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameTYSHONNA DOMRAE JORDAN
Location Address12318 BOYDTON PLANK RD.Dinwiddie, VA 23841
Mailing Address5310 Moody DrNorth Dinwiddie, VA 23803-8706
Phone(804) 504-9089
Sole ProprietorNo
Enumeration DateJanuary 12, 2018
Last NPPES UpdateApril 12, 20212 updates tracked since enumeration
NPPES CertifiedApril 12, 2021
✔ NPI 1225546153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
12318 BOYDTON PLANK RD., Dinwiddie, VA 23841
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyshonna Jordan's NPI number?

The NPI number for Tyshonna Jordan is 1225546153. It was assigned to this individual provider in the NPPES registry on January 12, 2018.

Where is Tyshonna Jordan located?

Tyshonna Jordan practices at 12318 Boydton Plank Rd., Dinwiddie, VA 23841. The listed phone number is (804) 504-9089.

What is Tyshonna Jordan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Tyshonna Jordan was last updated on April 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.