Healthcare Provider Details

I. General information

NPI: 1457095002
Provider Name (Legal Business Name): JASON STRZEPEK LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 10/23/2026
Certification Date: 10/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CUMMINGS CTR STE 3100
BEVERLY MA
01915-6540
US

IV. Provider business mailing address

500 CUMMINGS CTR STE 3100
BEVERLY MA
01915-6540
US

V. Phone/Fax

Practice location:
  • Phone: 978-921-4000
  • Fax: 978-921-7530
Mailing address:
  • Phone: 978-921-4000
  • Fax: 978-921-7530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10006273
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: