JACQUELINE SURDAN (LMHC) – Mental Health Counselor, NPI 1902432396

JACQUELINE SURDAN (LMHC) is a healthcare provider. based in Somerville, Massachusetts. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LMHC. They hold a License No. LMHC10002078 (MA). The NPI Number for JACQUELINE SURDAN (LMHC) is 1902432396

Main info

Female
5 Years Of Experience
Name
JACQUELINE SURDAN (LMHC)
NPI
1902432396
Phone
Not provided
Address
45 CHETWYND RD APT 2
Enumeration Date
17 March 2020
Last Update Date
24 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7812182377
Graduation Year
2021 (5 years ago)
PAC ID
6608389614
Group Practice PAC ID
4486181625
Professional Enrollment ID
I20250702001677
Address ID
MA018902940WI540XXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,116 MENTAL HEALTH COUNSELOR in MA

Provider Addresses for JACQUELINE SURDAN (LMHC)

  • 45 CHETWYND RD APT 2

    SOMERVILLE, MA 021441217

    Phone:

    Type: Mailing

  • 409 LEXINGTON ST

    WALTHAM, MA 024520933

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250702001677IMental Health CounselorMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02144)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486181625View full group profile
NameSpecialtyState
Mental Health CounselorMA
Mental Health CounselorMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

How do I look up JACQUELINE SURDAN (LMHC) by NPI?
Use NPI 1902432396 when you need to reference JACQUELINE SURDAN (LMHC) in forms, claims, or directories.
Does this profile mean JACQUELINE SURDAN (LMHC) is currently active?
Yes — JACQUELINE SURDAN (LMHC) appears active in the national provider directory.
Can you summarize JACQUELINE SURDAN (LMHC)'s specialty in plain language?
Clinically, the directory lists JACQUELINE SURDAN (LMHC) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where is JACQUELINE SURDAN (LMHC)'s primary listing?
We display Somerville, Massachusetts because that is what the record indicates for JACQUELINE SURDAN (LMHC).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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