Active NPI
Mathieu Ryan Peloquin, CRC
- Mental Health Counselor
- Springfield, MA
National Provider Identifier
1669973533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 140 High St
Springfield, MA 01105-1442 - Phone
- (413) 495-1500
- NPI assigned
- Feb 26, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
140 High St
Springfield, MA 01105-1442
Mailing address
21 Sutton PL Apt 2
Agawam, MA 01001-1433
Phone (401) 263-8993
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 952693142 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1669973533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 SUTTON PL APT 2",
"city": "AGAWAM",
"state": "MA",
"postal_code": "010011433",
"telephone_number": "401-263-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HIGH ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011051442",
"telephone_number": "413-495-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELOQUIN",
"first_name": "MATHIEU",
"middle_name": "RYAN",
"credential": "CRC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "952693142",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.