Active NPI
Jordan Goldklang
- Marriage & Family Therapist
- Wood Ridge, NJ
National Provider Identifier
1053195628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 37AC00723600
- Practice address
- 218 Jay St
Wood Ridge, NJ 07075-1507 - Phone
- (201) 566-2783
- NPI assigned
- Aug 23, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 37AC00723600 | NJ | Primary |
Addresses
Primary practice location
218 Jay St
Wood Ridge, NJ 07075-1507
Mailing address
218 Jay St
Wood Ridge, NJ 07075-1507
Phone (201) 566-2783
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 |
|---|---|---|---|
| 37AC00723600 | NJ | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1053195628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 JAY ST",
"city": "WOOD RIDGE",
"state": "NJ",
"postal_code": "070751507",
"telephone_number": "201-566-2783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 JAY ST",
"city": "WOOD RIDGE",
"state": "NJ",
"postal_code": "070751507",
"telephone_number": "201-566-2783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDKLANG",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NJ",
"license": "37AC00723600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wood Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.