ELEACIA LERAYNE JORDAN
NPI 1902690977
Peer Specialist in Stilwell, OK

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

Active since April 07, 2025

611 N 4TH ST, STILWELL, OK 74960(918) 696-6212 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Eleacia Lerayne Jordan NPPES

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

ELEACIA LERAYNE JORDAN (NPI 1902690977) is an individual peer specialist in Stilwell, Oklahoma and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1902690977

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameELEACIA LERAYNE JORDAN

Location Address611 N 4TH STStilwell, OK 74960-2417

Mailing Address611 N 4th StStilwell, OK 74960-2417 · (918) 696-6212

Phone(918) 696-6212

Sole ProprietorYes

Enumeration DateApril 7, 2025

NPPES CertifiedApril 6, 2025

✔ NPI 1902690977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

611 N 4TH ST, Stilwell, OK 74960

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VALERIE J MCCLURE

Case Manager/Care Coordinator