MEDICARE: CHRISTIAN FAITH COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457208654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN FAITH COUNSELING PLLC

Provider Business Mailing Address
First Line	:	501 W 26TH ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-4918
Country	:	US
Telephone Number	:	336-926-2017
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 W 26TH ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-4918
Country	:	US
Telephone Number	:	336-926-2017
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LCMHCS
Name	:	JANELL LAFAYE JORDAN
Credential	:	LCMHCS
Telephone Number	:	336-926-2017

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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