Active NPI
Jordan Faigen
- Marriage & Family Therapist
- Madison, CT
National Provider Identifier
1033814546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3090
- Practice address
- 71 Bradley Rd Ste 2&3
Madison, CT 06443-2662 - Phone
- (203) 453-2999
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3090 | CT | Primary |
Addresses
Primary practice location
71 Bradley Rd Ste 2&3
Madison, CT 06443-2662
Mailing address
15 Cedar Grove Ter
Essex, CT 06426-1453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3090 | CT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1033814546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 CEDAR GROVE TER",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 BRADLEY RD STE 2&3",
"city": "MADISON",
"state": "CT",
"postal_code": "064432662",
"telephone_number": "203-453-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIGEN",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2023-04-03",
"certification_date": "2023-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "3090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.