Jannelis I Medina

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1985 Main St Ste 305
Springfield, MA 01103-1074

Phone

(413) 885-3965

NPI assigned

Sep 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Bridge of Changes, LLC

  • Mental Health Counselor
  • Springfield, MA
  • NPI 1710597406

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1730801283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 MAIN ST STE 305",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031074",
            "telephone_number": "413-885-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 MAIN ST STE 305",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031074",
            "telephone_number": "413-885-3965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018525310",
            "country_code": "US",
            "telephone_number": "978-332-6524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JANNELIS",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Diagnostics and Rehabilitation LLC
• Medical Express Urgent Care Center, Co. Inc.
• Medicine Centre LTC LLC
• Erica Medina Serrano
• Alex Medina
• Yadirys Del Carmen Medina
• Yury Natalia Medina
• Paul Medrek, MD
• Lynn Marie Meffen, LICSW
• Susan Marie Megas, RN, MSN,CS

• Addiction (Substance Use Disorder) Counselor in Springfield, MA
• Providers in Springfield, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.