Individual provider Active NPI

Jordan Stewart, PSYD

  • Counselor
  • Saratoga Springs, NY
National Provider Identifier
1962057513
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
210 Church St
Saratoga Springs, NY 12866-1010
Phone
(518) 580-0520
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220119000047 NY Practitioner - Clinical Psychologist 8921490228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024025NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ecs Wellness Psychology CurrentSince Oct 6, 2019 Accepting new patients

Locations

210 Church St
Saratoga Springs, NY 12866
Phone (518) 580-0520

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

210 Church St
Saratoga Springs, NY 12866-1010

Mailing address

2 Fisher St
Greenwich, NY 12834-1135
Phone (630) 336-5011

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2019.

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1962057513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FISHER ST",
            "city": "GREENWICH",
            "state": "NY",
            "postal_code": "128341135",
            "telephone_number": "630-336-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661010",
            "telephone_number": "518-580-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JORDAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.