Individual provider Active NPI

Jeffrey Paul Kassis, LICSW

  • Clinical Social Worker
  • Springfield, MA
National Provider Identifier
1679780258
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103979 Issued in MA
Practice address
417 Liberty St
Springfield, MA 01104-3736
Phone
(413) 301-9337
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 103979 MA Primary

Addresses

Primary practice location

417 Liberty St
Springfield, MA 01104-3736

Mailing address

80 Morgan Cir
Amherst, MA 01002-1131

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
103979MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Counseling Center, Inc Clinical PastSince Jul 19, 1994 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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1679780258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MORGAN CIR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010021131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-301-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIS",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103979",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 28, 2011; 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.