Individual provider Active NPI

John Hollis Meiklejohn, LICSW, BCD

  • Mental Health Counselor
  • Westfield, MA
National Provider Identifier
1164430575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
104424 Issued in MA
Practice address
45 Broad St
Westfield, MA 01085-2956
Phone
(413) 568-9858
Fax
(413) 568-6492
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 104424 MA Primary

Addresses

Primary practice location

45 Broad St
Westfield, MA 01085-2956

Mailing address

183 Silver St
Granville, MA 01034-9476
Phone (413) 357-6342

Other identifiers 3

IdentifierTypeStateIssuer
P02478OtherMABC/BS ID NUMBER
495584OtherMATUFTS ID NUMBER
272826OtherMAMBC IDENTIFICATION NUMBER

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

State licenses

LicenseStateTypeSpecialty
104424MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164430575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 SILVER ST",
            "city": "GRANVILLE",
            "state": "MA",
            "postal_code": "010349476",
            "telephone_number": "413-357-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852956",
            "telephone_number": "413-568-9858",
            "fax_number": "413-568-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIKLEJOHN",
        "first_name": "JOHN",
        "middle_name": "HOLLIS",
        "name_prefix": "Mr.",
        "credential": "LICSW, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "104424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ID NUMBER",
            "identifier": "P02478",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ID NUMBER",
            "identifier": "495584",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBC IDENTIFICATION NUMBER",
            "identifier": "272826",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.