Active NPI
Judith M Jorgensen
- Psychologist
- Madison, CT
National Provider Identifier
1861610479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20010513A
- Practice address
- 17 Wall St
Madison, CT 06443-3122 - Phone
- (203) 318-0742
- NPI assigned
- Apr 22, 2007
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 001500 | CT | |
| Psychologist | 103T00000X | 20010513A | IN | Primary |
Addresses
Primary practice location
17 Wall St
Madison, CT 06443-3122
Mailing address
PO Box 377
Madison, CT 06443-0377
Phone (203) 318-0742
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001500 | CT | MD | Professional Counselor |
| 20010513A | IN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1861610479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 377",
"city": "MADISON",
"state": "CT",
"postal_code": "064430377",
"telephone_number": "203-318-0742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WALL ST",
"city": "MADISON",
"state": "CT",
"postal_code": "064433122",
"telephone_number": "203-318-0742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "JUDITH",
"middle_name": "M",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-22",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "001500",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20010513A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.