Active NPI
Jessica Surrett, PH.D.
- Forensic Psychologist
- Stoughton, MA
National Provider Identifier
1063669760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 9701
- Practice address
- 1044 Central St
Suite 201
Stoughton, MA 02072-4423 - Phone
- (781) 437-7513
- NPI assigned
- Aug 25, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 9701 | MA | Primary |
| Clinical Psychologist | 103TC0700X | 9701 | MA |
Addresses
Primary practice location
1044 Central St
Suite 201
Stoughton, MA 02072-4423
Mailing address
1044 Central St
Suite 201
Stoughton, MA 02072-4423
Phone (781) 437-7513
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9701 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380326400000",
"number": "1063669760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 CENTRAL ST",
"address_2": "SUITE 201",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020724423",
"telephone_number": "781-437-7513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 CENTRAL ST",
"address_2": "SUITE 201",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020724423",
"telephone_number": "781-437-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURRETT",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-25",
"last_updated": "2013-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MA",
"license": "9701",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9701",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.