Active NPI
Jaime R Suvak, LMHC
- Mental Health Counselor
- Cambridge, MA
National Provider Identifier
1396979100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5433
- Practice address
- 675 Massachusetts Ave
Floor 11, Psychotherapy Suite
Cambridge, MA 02139-3309 - Phone
- (781) 395-2515
- NPI assigned
- May 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 5433 | MA | Primary |
Addresses
Primary practice location
675 Massachusetts Ave
Floor 11, Psychotherapy Suite
Cambridge, MA 02139-3309
Mailing address
62 Medford St
Medford, MA 02155-6524
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5433 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1396979100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MEDFORD ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021556524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 MASSACHUSETTS AVE",
"address_2": "FLOOR 11, PSYCHOTHERAPY SUITE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021393309",
"telephone_number": "781-395-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUVAK",
"first_name": "JAIME",
"middle_name": "R",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-07",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "5433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.