Individual provider Active NPI

Jean Surma, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Jamestown, NY
National Provider Identifier
1497020069
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
086054 Issued in NY
Practice address
200 E 3Rd St
5TH Floor Muncipal Building
Jamestown, NY 14701-5433
Phone
(716) 661-8330
Fax
(716) 753-4230
NPI assigned
Mar 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 086054 NY
Addiction (Substance Use Disorder) Counselor 101YA0400X 086054 NY Primary

Addresses

Primary practice location

200 E 3Rd St
5TH Floor Muncipal Building
Jamestown, NY 14701-5433

Mailing address

7 N Erie St
Mayville, NY 14757-1095
Phone (716) 753-4104

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

LicenseStateTypeSpecialty
086054NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Chautauqua - a Mun Corp PastSince Aug 1, 1996 Accepting new patients
County of Chautauqua - a Mun Corp Past Accepting new patients

Organizations & group practices 2

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1497020069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N ERIE ST",
            "city": "MAYVILLE",
            "state": "NY",
            "postal_code": "147571095",
            "telephone_number": "716-753-4104",
            "fax_number": "716-753-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 3RD ST",
            "address_2": "5TH FLOOR MUNCIPAL BUILDING",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015433",
            "telephone_number": "716-661-8330",
            "fax_number": "716-753-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURMA",
        "first_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "086054",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "086054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.