Individual provider Active NPI

Jaime Santiago, MED, LMHC

  • Mental Health Counselor
  • Chicopee, MA
National Provider Identifier
1003017815
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8229 Issued in MA
Practice address
10 Center St Ste 210
Chicopee, MA 01013-2870
Phone
(413) 273-3736
Fax
(413) 961-0893
NPI assigned
May 30, 2007
Last updated
Oct 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8229 MA Primary

Addresses

Primary practice location

10 Center St Ste 210
Chicopee, MA 01013-2870

Mailing address

10 Center St Ste 210
Chicopee, MA 01013-2870
Phone (413) 273-3736

Other practice location 1

125 Liberty St Ste 402
Springfield, MA 01103-1109
Phone (413) 391-7815

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)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
8229MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Behavioral Health LLC CurrentSince Jul 20, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1003017815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTER ST STE 210",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010132870",
            "telephone_number": "413-273-3736",
            "fax_number": "413-961-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTER ST STE 210",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010132870",
            "telephone_number": "413-273-3736",
            "fax_number": "413-961-0893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Liberty St Ste 402",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011031109",
            "country_code": "US",
            "telephone_number": "413-391-7815",
            "fax_number": "413-310-3378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JAIME",
        "name_prefix": "Mr.",
        "credential": "MED, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "8229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.