Jeremy Anderson, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

110 Boston St
Salem, MA 01970-1402

Phone

(612) 730-5903

NPI assigned

May 30, 2018

Last updated

May 30, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Justice Resource Institute, IncGroup PAC ID 3274430590, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Justice Resource Institute, Inc.

  dba JRI Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salem, MA
  • NPI 1093787095
  Medicare reassignment Care Compare group NPD
• Justice Resource Institute, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Acton, MA
  • NPI 1295909760
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1982196606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 KINGS BEACH TER",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071918",
            "telephone_number": "612-730-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BOSTON ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701402",
            "telephone_number": "612-730-5903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Kings Beach Ter",
            "address_purpose": "LOCATION",
            "city": "Swampscott",
            "state": "MA",
            "postal_code": "019071918",
            "country_code": "US",
            "telephone_number": "612-730-5903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEREMY",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Folashade Amosun
• Amy Carlson-Pallazola, LMHC, LLC
• Stephanie Amyot
• Anaesthesia Associates of Massachusetts, PC (New England Pain Management Consultants)
• Jennifer Anderson
• Mark R Anderson, M.D.
• Robin Anderson, MS, LMHC, LSW
• Sandra Anderson, LICSW, LCSW
• Brittani Andler, LICSW
• Andrea Chisholm MD LLC

• Mental Health Counselor in Salem, MA
• Providers in Salem, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.