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Deactivated NPI 1942540372 Deactivated / Inactive NPI Male Practitioner

Jonathan Etesse

Counselor • Medford, MA

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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.

Registration / Start Date February 21, 2013
NPI Deactivation Date May 13, 2018
Total Practice Duration ~5 Years of Practice (2013 – 2018)

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

Practice Address

1090 Fellsway

Medford, MA 021552834

Telephone 7818663105

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Medford, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.0 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
43 Specialists

Practicing in Medford, MA (9162 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

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

8 Historical Events
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NPI Profile Deactivated May 13, 2018

Record deactivated on May 13, 2018

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NPI Profile Deactivated May 12, 2018

Record deactivated on May 12, 2018

NPI Profile Active February 21, 2013

NPI status registered as active in NPPES database

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Updated Practice Location February 21, 2013

Registered at 1090 FELLSWAY, MEDFORD, MA 021552834 (Tel: 7818663105)

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Updated Business Mailing Address February 21, 2013

Registered at 1090 FELLSWAY, MEDFORD, MA 021552834 (Tel: 7818663105)

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Provider Name / Credentials Updated February 21, 2013

Recorded as JONATHAN ETESSE

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2013

Counselor

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Initial NPI Registration & Enumeration February 21, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1942540372
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2013
Last Update: February 21, 2013
Deactivation Date: May 13, 2018

Mailing Address

1090 Fellsway

Medford, MA 021552834

Phone: 7818663105

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.