Lydia Jordan, LCSW, LCADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05682400 Issued in NJ

Practice address

1 Brookfield Glen Dr
Belvidere, NJ 07823-2854

Phone

(908) 652-5311

NPI assigned

Nov 3, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 16, 2024 through Nov 16, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1023560208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKFIELD GLEN DR",
            "city": "BELVIDERE",
            "state": "NJ",
            "postal_code": "078232854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKFIELD GLEN DR",
            "city": "BELVIDERE",
            "state": "NJ",
            "postal_code": "078232854",
            "telephone_number": "908-652-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LYDIA",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00277200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05682400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Beverly Herring
• Michelle Anne Hiller, OTR/L
• Bonnie E Jantzen
• John P Fritz DO PC
• Rebekah Lynne Johnson, LCSW, LCADC
• Scott J Jordan, DPT
• Jacqueline Mele Kaufman, RPH
• Nicholas Michael Kavcsak, O.D.
• Kelli Kennedy, CMA, NAVIGATOR
• Demetrios Agis Kydonieus, DC

• Clinical Social Worker in Belvidere, NJ
• Providers in Belvidere, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.