Provider Demographics
NPI:1952775223
Name:KAPP, JORDAN (MA)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:KAPP
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CRAIN RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4017
Mailing Address - Country:US
Mailing Address - Phone:347-432-1721
Mailing Address - Fax:
Practice Address - Street 1:121 CRAIN RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4017
Practice Address - Country:US
Practice Address - Phone:201-370-4283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00537200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional