Jordan Heiden

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00574400 Issued in NJ

Practice address

300 W Mount Vernon Ave
Haddonfield, NJ 08033-2524

Phone

(845) 208-4671

NPI assigned

Feb 17, 2016

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 10, 2024 through Jan 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1336508514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MOUNT VERNON AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332524",
            "telephone_number": "407-552-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MOUNT VERNON AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332524",
            "telephone_number": "845-208-4671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 S Sherbourne Dr Apt 308",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900352145",
            "country_code": "US",
            "telephone_number": "805-410-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDEN",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00574400",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "007510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haddonfield Vision P.C.
• Lisa Hardenbrook, LCSW
• Holly M Hargrove, PA-C
• Sarah Hastings, IBCLC
• Brittany Nicole Haug, L.AC
• Karen Heinbach, BA
• Alayna Gabbrielle Henry
• Illiana Ann Herishko
• Nicole Christina Heron, LCSW
• Tracey Hess

• Professional Counselor in Haddonfield, NJ
• Providers in Haddonfield, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.