Shacarah L Fordjour, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

37PC00674300 Issued in NJ

Practice address

90 Delaware Ave
2ND FL
Paterson, NJ 07503-1804

Phone

(973) 321-2271

Fax

(973) 321-2254

NPI assigned

Oct 31, 2007

Sex

Female

Sole proprietor

No

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 NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Safe Place Counseling and Therapy CenterGroup PAC ID 6204376544, 7 clinicians

Princeton House Provider Group LLCGroup PAC ID 0244540540, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Princeton House Provider Group LLC

  • Psychiatry Physician
  • Princeton, NJ
  • NPI 1881078681
  Medicare reassignment Care Compare group NPD
• Safe Place Counseling and Therapy Center

  • Mental Health Counselor
  • Skillman, NJ
  • NPI 1467048900
  Medicare reassignment Care Compare group NPD
• DRX Paramus, LLC

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  Medicare reassignment NPD
• Safe Therapy, Inc.

  • Mental Health Counselor
  • Skillman, NJ
  • NPI 1750016382
  Medicare reassignment NPD
• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  • Psychiatric Hospital Unit
  • Princeton, NJ
  • NPI 1518009588
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1982883443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 DELAWARE AVE",
            "address_2": "2ND FL",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031804",
            "telephone_number": "973-321-2271",
            "fax_number": "973-321-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 DELAWARE AVE",
            "address_2": "2ND FL",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031804",
            "telephone_number": "973-321-2271",
            "fax_number": "973-321-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDJOUR",
        "first_name": "SHACARAH",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00166500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "37PC00674300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hafsa Foda
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• Foot Care of Jersey Corporation
• Casey Janine Ford
• William E Ford
• Forever Healing Home Health Services
• Forever Healing Home Health Services
• Ali Forghani
• Robert Fornini
• Mohamed Fouad, PHARMD/MD

• Psychiatric/Mental Health Nurse Practitioner in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.