Jean Vernet Souffrant Sr., MA NCPSYA

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

0001361 Issued in NY

Practice address

110-17 37TH Avenue
Corona, NY 11368

Phone

(718) 429-1825

Fax

(718) 565-2086

NPI assigned

Aug 7, 2007

Last updated

Aug 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jean V Souffrant Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1881885440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110-17 37TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-429-1825",
            "fax_number": "718-565-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-17 37TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-429-1825",
            "fax_number": "718-565-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUFFRANT",
        "first_name": "JEAN",
        "middle_name": "VERNET",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MA NCPSYA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003761",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "0001361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "SOUFFRANT",
            "middle_name": "V",
            "credential": "PSYCHOANALYST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychoanalyst in Corona, NY
• Providers in Corona, NY by specialty
• Psychoanalyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.