Individual provider Active NPI

Jason Edward Smith

  • Mental Health Counselor
  • Salem, MA
National Provider Identifier
1174714711
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
41 Mason St Unit 4
Salem, MA 01970-2253
Phone
(978) 744-1585
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 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 Primary

Addresses

Primary practice location

41 Mason St Unit 4
Salem, MA 01970-2253

Mailing address

42 Forest St
Manchester, MA 01944-1209
Phone (617) 935-3451

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

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1174714711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 FOREST ST",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441209",
            "telephone_number": "617-935-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MASON ST UNIT 4",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702253",
            "telephone_number": "978-744-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

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