Jordan Constance, MA

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

30 Warren St
Boston, MA 02135-3602

Phone

(617) 254-3800

NPI assigned

Sep 6, 2016

Sex

Female

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

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Children'S Health System of Texas

  • Children's Hospital
  • Dallas, TX
  • NPI 1194743013
  Medicare reassignment NPD
• Children'S Health System of Texas

  • Community/Retail Pharmacy
  • Dallas, TX
  • NPI 1881830602
  NPD

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1467909671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WARREN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021353602",
            "telephone_number": "617-254-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WARREN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021353602",
            "telephone_number": "617-254-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANCE",
        "first_name": "JORDAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Ann Conroy
• Michael Francis Conroy, LADCI
• Stacey Cori Conroy, LCSW
• Sarah Marie Consbruck
• Marcella Speranza Consiglio, RTR, VI
• Katherine Putnam Constantin, PMHNP-BC
• Elizabeth Margaret Constantine
• Maria I. Constantine, PA-C
• Steven Kyriakos Constantino Jr., MD
• Fady Constantinos, M.D.

• Clinical Child & Adolescent Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.