Individual provider Active NPI

Jordan Madison, LAC

  • Mental Health Counselor
  • Paramus, NJ
National Provider Identifier
1417834615
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00902800 Issued in NJ
Practice address
140 E Ridgewood Ave Ste 415
Paramus, NJ 07652-3915
Phone
(201) 820-7380
NPI assigned
Aug 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 37AC00902800 NJ Primary

Addresses

Primary practice location

140 E Ridgewood Ave Ste 415
Paramus, NJ 07652-3915

Mailing address

5 Pitcairn Ave
Ho Ho Kus, NJ 07423-1622
Phone (201) 820-7380

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

LicenseStateTypeSpecialty
37AC00902800NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1417834615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PITCAIRN AVE",
            "city": "HO HO KUS",
            "state": "NJ",
            "postal_code": "074231622",
            "telephone_number": "201-820-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E RIDGEWOOD AVE STE 415",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523915",
            "telephone_number": "201-820-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "JORDAN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00902800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.