Individual provider Active NPI

Jamie Gilliam

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1487961975
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2155 Main St
Springfield, MA 01104-3301
Phone
(413) 736-0395
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

2155 Main St
Springfield, MA 01104-3301

Mailing address

2155 Main St
Springfield, MA 01104-3301
Phone (413) 736-0395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805001872 MA Practitioner - Mental Health Counselor 4284142704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gandara Mental Health Center IncGroup PAC ID 4486544525, 7 clinicians

Practice addresses (Care Compare)

2155 Main St
Springfield, MA 01104-3301
Phone (413) 736-0395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9073MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gandara Mental Health Center Inc Mental Health CurrentSince Jul 1, 2025 Accepting new patients

Locations

933 E Columbus Ave
Springfield, MA 01105
Phone (413) 301-6019

85 Saint George Rd
Springfield, MA 01104
Phone (413) 732-2120

2155 Main St
Springfield, MA 01104
Phone (413) 736-0395

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1487961975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043301",
            "telephone_number": "413-736-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043301",
            "telephone_number": "413-736-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.