Active NPI
Jacques Lucien Trudel, M.A.,LADC I
- Addiction (Substance Use Disorder) Counselor
- Worcester, MA
National Provider Identifier
1801805643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1645
- Practice address
- 12 Queen Street
Worcester, MA 01610 - Phone
- (508) 438-5583
- Fax
- (508) 421-4362
- NPI assigned
- Aug 7, 2006
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1645 | MA | Primary |
Addresses
Primary practice location
12 Queen Street
Worcester, MA 01610
Mailing address
795 Alpine Dr
Southbridge, MA 01550-3957
Phone (508) 438-5583
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1645 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801805643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 ALPINE DR",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015503957",
"telephone_number": "508-438-5583",
"fax_number": "508-421-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 QUEEN STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01610",
"telephone_number": "508-438-5583",
"fax_number": "508-421-4362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUDEL",
"first_name": "JACQUES",
"middle_name": "LUCIEN",
"name_prefix": "Mr.",
"credential": "M.A.,LADC I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "1645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.