Jeremy Anderson, MA
Individual provider Active NPI Mental Health Counselor · Salem, MA
NPI 1982196606 · NPPES record last updated May 30, 2018
Key facts
- NPI
- 1982196606
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 110 Boston St
Salem, MA 01970-1402 - Phone
- (612) 730-5903
- NPI assigned
- May 30, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Justice Resource Institute, Inc
Practice addresses (Care Compare)
110 Boston St
Salem, MA 01970-1402
Phone (978) 744-7905
380 Massachusetts Ave
Acton, MA 01720-3743
Phone (978) 264-3619
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240516001492 | MA | Practitioner - Mental Health Counselor | 6406297894 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Justice Resource Institute, Inc. | Current |
Accepting new patients | |
| Justice Resource Institute, Inc | Past | Accepting new patients |
Locations
380 Massachusetts Ave
Acton, MA 01720
Phone (978) 263-3006
160 Gould St
Ste 300
Needham Heights, MA 02494
Phone (781) 559-4900
110 Boston St
Salem, MA 01970
Phone (781) 592-5691
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
110 Boston St
Salem, MA 01970-1402
Mailing address
15 Kings Beach Ter
Swampscott, MA 01907-1918
Phone (612) 730-5903
Other practice location 1
15 Kings Beach Ter
Swampscott, MA 01907-1918
Phone (612) 730-5903
Other providers in Salem, MA
- Folashade Amosun
- Amy Carlson-Pallazola, LMHC, LLC
- Stephanie Amyot
- Anaesthesia Associates of Massachusetts, PC
- Jennifer Anderson
- Mark R Anderson
- Robin Anderson
- Sandra Anderson
- Brittani Andler
- Andrea Chisholm MD LLC
All providers in Salem, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.