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JORDAN L GOLDBERG LADC
NPI 1235720665
Counselor - Addiction (Substance Use Disorder) in Enfield, CT

Active since January 28, 2021PECOS Enrolled
153 HAZARD AVE, ENFIELD, CT 06082(860) 253-5020(860) 731-5536 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 18, 2025, Jan 28, 2021 (2 updates tracked since 2021).

About Jordan L Goldberg Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN L GOLDBERG LADC (NPI 1235720665) is an individual addiction (substance use disorder) provider in Enfield, Connecticut, licensed in Connecticut (1651) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1235720665
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJORDAN L GOLDBERGCredential: LADC
Location Address153 HAZARD AVEEnfield, CT 06082-4592
Mailing Address2 Waterside Xing Ste 401Windsor, CT 06095-1588 · (860) 731-5522 · Fax (860) 731-5536
Phone(860) 253-5020
Fax(860) 731-5536
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJanuary 28, 2021
Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration
NPPES CertifiedDecember 18, 2025
✔ NPI 1235720665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CT · 1651
Also ListedCounselorTaxonomy 101Y00000X
153 HAZARD AVE, Enfield, CT 06082
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan L Goldberg Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385130384
PECOS Enrollment IDI20251229003654
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jordan Goldberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Resources, Inc.
0.2 mi
Primary Care
153 HAZARD AVE
Enfield, CT 06082
  • Reassigned Medicare billing, Connecticut enrollment
  • 227 clinicians in this Medicare group
NPI 1346700093 (860) 253-5020

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHALIAR DREW
Counselor (Mental Health)
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (860) 253-5020
JULIANNE BERNSTEIN
Student in an Organized Health Care Education/Training Program
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (860) 253-5020
MEILINE SMITH
Marriage & Family Therapist
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (860) 253-5020
MONICA E CRIMMINS
Counselor (Mental Health)
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (877) 884-3571
KEVIN LENIART
Counselor
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (860) 253-5020
AMY KINGSBURY
Counselor
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (860) 731-5522
ALEXA A LIUCCI
Counselor (Mental Health)
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (877) 884-3571
JOHN A TINNIRELLA
Counselor (Mental Health)
153 HAZARD AVE
ENFIELD, CT 06082
Capitol Planning Region (877) 884-3571

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Goldberg's NPI number?

The NPI number for Jordan Goldberg is 1235720665. It was assigned to this individual provider in the NPPES registry on January 28, 2021.

Where is Jordan Goldberg located?

Jordan Goldberg practices at 153 Hazard Ave, Enfield, CT 06082. The listed phone number is (860) 253-5020.

What is Jordan Goldberg's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Jordan Goldberg enrolled in Medicare?

Yes. Jordan Goldberg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jordan Goldberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Goldberg reassigns Medicare benefits to Community Health Resources, Inc. (Enfield, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Goldberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jordan Goldberg was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.