Active NPI
Jason Sutton
- Mental Health Counselor
- Glen Burnie, MD
National Provider Identifier
1174819320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC3300
- Practice address
- 122 Langley Rd N Ste a
Glen Burnie, MD 21060-6531 - Phone
- (410) 222-6785
- NPI assigned
- Jun 27, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC3300 | MD | Primary |
Addresses
Primary practice location
122 Langley Rd N Ste a
Glen Burnie, MD 21060-6531
Mailing address
3010 Grand Ave
Waukegan, IL 60085-2321
Phone (847) 377-8106
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC3300 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1174819320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852321",
"telephone_number": "847-377-8106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 LANGLEY RD N STE A",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210606531",
"telephone_number": "410-222-6785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-27",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC3300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.