Active NPI
Jacob Nolin
- Mental Health Counselor
- Methuen, MA
National Provider Identifier
1477312064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- S60659723
- Practice address
- 51 Osgood St Apt T704
Methuen, MA 01844-3018 - Phone
- (351) 667-5428
- NPI assigned
- Mar 15, 2024
- Sex
- Male
- 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 | S60659723 | MA | Primary |
Addresses
Primary practice location
51 Osgood St Apt T704
Methuen, MA 01844-3018
Mailing address
51 Osgood St Apt T704
Methuen, MA 01844-3018
Phone (351) 667-5428
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 |
|---|---|---|---|
| S60659723 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710460800000",
"number": "1477312064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 OSGOOD ST APT T704",
"city": "METHUEN",
"state": "MA",
"postal_code": "018443018",
"telephone_number": "351-667-5428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 OSGOOD ST APT T704",
"city": "METHUEN",
"state": "MA",
"postal_code": "018443018",
"telephone_number": "351-667-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLIN",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-15",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "S60659723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Methuen, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.