Jonathan Etesse
Counselor • Medford, MA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jonathan Etesse has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Jonathan Etesse was a registered Counselor practicing in Medford, MA. Throughout an active medical career spanning 5 years, Jonathan Etesse provided care at the practice location at 1090 FELLSWAY until profile deactivation on 2018-05-13.
Practice Location & Contact Primary Location
1090 Fellsway
Medford, MA 021552834
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor in Medford, MA
Practicing in Medford, MA (9162 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 13, 2018
Record deactivated on May 12, 2018
NPI status registered as active in NPPES database
Registered at 1090 FELLSWAY, MEDFORD, MA 021552834 (Tel: 7818663105)
Registered at 1090 FELLSWAY, MEDFORD, MA 021552834 (Tel: 7818663105)
Recorded as JONATHAN ETESSE
Counselor
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1090 Fellsway
Medford, MA 021552834
Phone: 7818663105
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