Individual provider Active NPI

Jordan Nicole Kaufman, MA, LMHC

  • Mental Health Counselor
  • Cambridge, MA
National Provider Identifier
1386321537
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10000853 Issued in MA
Practice address
875 Massachusetts Ave Ste 4-1
Cambridge, MA 02139-3067
Phone
(617) 996-8821
Fax
(617) 812-1697
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC10000853 MA Primary

Addresses

Primary practice location

875 Massachusetts Ave Ste 4-1
Cambridge, MA 02139-3067

Mailing address

875 Massachusetts Ave Ste 4-1
Cambridge, MA 02139-3067
Phone (617) 996-8821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Matters Practice PLLC CurrentSince Jan 1, 2024 Accepting new patients
Boston Expressive Arts Therapy Services LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

875 Massachusetts Ave
Ste 4
Cambridge, MA 02139
Phone (513) 638-2323

875 Massachusetts Ave
Ste 1
Cambridge, MA 02139

875 Massachusetts Ave
Ste 41
Cambridge, MA 02139
Phone (617) 497-2124

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1386321537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE STE 4-1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "617-996-8821",
            "fax_number": "617-812-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE STE 4-1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "617-996-8821",
            "fax_number": "617-812-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-12-27",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.