Active NPI
Jessica M Souffrant
- Mental Health Counselor
- Saugus, MA
National Provider Identifier
1508163296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 9061
- Practice address
- 99 Walnut St Ste F
Saugus, MA 01906-1980 - Phone
- (781) 715-3697
- NPI assigned
- Feb 16, 2011
- Sex
- Female
- 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 | 9061 | MA | Primary |
Addresses
Primary practice location
99 Walnut St Ste F
Saugus, MA 01906-1980
Mailing address
23 Central Ave
Lynn, MA 01901-1220
Phone (781) 477-7222
Other practice location 1
269 Union St
Lynn, MA 01901-1314
Phone (781) 596-2502 ext. 701
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 |
|---|---|---|---|
| 9061 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lynn Community Health, Inc. | Past | Accepting new patients |
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.
-
- Health Service Clinic/Center
- Lynn, MA
- NPI 1912215120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586476800000",
"number": "1508163296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 CENTRAL AVE",
"city": "LYNN",
"state": "MA",
"postal_code": "019011220",
"telephone_number": "781-477-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 WALNUT ST STE F",
"city": "SAUGUS",
"state": "MA",
"postal_code": "019061980",
"telephone_number": "781-715-3697"
}
],
"practiceLocations": [
{
"address_1": "269 Union St",
"address_purpose": "LOCATION",
"city": "Lynn",
"state": "MA",
"postal_code": "019011314",
"country_code": "US",
"telephone_number": "781-596-2502 x701",
"fax_number": "781-596-3966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOUFFRANT",
"first_name": "JESSICA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-16",
"last_updated": "2020-04-10",
"certification_date": "2020-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "9061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saugus, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.