Jeremy Lee Surratt

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

65043 Issued in TX

Practice address

5201 McCart Ave Ste H
Fort Worth, TX 76115-3700

Phone

(817) 761-7692

NPI assigned

Oct 2, 2026

Last updated

Oct 2, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1720982911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N JARVIS LN",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203326",
            "telephone_number": "817-718-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 MCCART AVE STE H",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761153700",
            "telephone_number": "817-761-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "65043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgical Services Group, Inc
• Surgicalist of TX PLLC
• Vidya Sri Suri, DDS
• Elizabeth Surita-Khuat, M.A., CCC-SLP
• Blaire Surley, OTR, CBIS
• Sajid Ali Surve, DO
• Survivor Gals Specialty Products and Salon LLC (Survivor Gals Specialty Products Fort Worth)
• Susan Arnold Lange, Psychologist, LPPC
• Susan K Linder MD PA
• Susan R. Bailey, M.D.P.a.

• Addiction (Substance Use Disorder) Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.