Active NPI
Adriana Jodoin, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1619585254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025093
- Practice address
- 185 Madison Ave Ste 1405
New York, NY 10016-4325 - Phone
- (646) 970-0579
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 025093 | NY | Primary |
Addresses
Primary practice location
185 Madison Ave Ste 1405
New York, NY 10016-4325
Mailing address
462 W 42ND St # 2533
New York, NY 10036-6805
Phone (646) 970-0579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 24, 2023 through Aug 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1619585254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 W 42ND ST # 2533",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100366805",
"telephone_number": "646-970-0579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 MADISON AVE STE 1405",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100164325",
"telephone_number": "646-970-0579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JODOIN",
"first_name": "ADRIANA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.