Active NPI
Jean Mario Surin
- Mental Health Counselor
- West Springfield, MA
National Provider Identifier
1750606901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2112 Riverdale Street
West Springfield, MA 01089 - Phone
- (413) 827-4375
- NPI assigned
- Mar 31, 2010
- Sex
- Male
- Sole proprietor
- Yes
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
2112 Riverdale Street
West Springfield, MA 01089
Mailing address
111 Lucerne Road
Springfield, MA 01119
Phone (845) 222-9314
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": "1269993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269993600000",
"number": "1750606901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 LUCERNE ROAD",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01119",
"telephone_number": "845-222-9314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 RIVERDALE STREET",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "01089",
"telephone_number": "413-827-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURIN",
"first_name": "JEAN",
"middle_name": "MARIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-31",
"last_updated": "2010-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.