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Organization
JODI PROVINCE COUNSELING SERVICES PLLC
Active
Organization
JODI PROVINCE COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI TILLEY PROVINCE MA, LPC, NCC (ORGANIZER/MEMBER)
(336) 818-0733
Entity
Organization
Contact information
Practice address
1260 COLLEGE AVE STE 1, WILKESBORO, NC 28697-2700
(336) 818-0733
(336) 818-0734
Mailing address
1260 COLLEGE AVE STE 1, WILKESBORO, NC 28697-2700
(336) 818-0733
(336) 818-0734
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
5534
NC
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144VW
BCBSNC
NC
05
—
6102745
—
NC
05
—
6103333
—
NC
05
—
6103527
—
NC
05
—
6105186
—
NC
05
—
6106369
—
NC
05
—
6107594
—
NC
05
—
6112147
—
NC
05
—
6112237
—
NC
Enumeration date
10/05/2009
Last updated
05/22/2026
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