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MISS JESSICA BRYNN SUPHAN
NPI 1093387797
Counselor - Mental Health in Malone, NY

Active since July 13, 2021Opted out of Medicare · through Dec 23, 2027
31 6TH ST, MALONE, NY 12953(518) 483-3261(518) 483-3383 Get Directions Write a Review

NPPES record last updated: November 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 15, 2024, Jul 13, 2021 (2 updates tracked since 2021).

About Miss Jessica Brynn Suphan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS JESSICA BRYNN SUPHAN (NPI 1093387797) is an individual mental health provider in Malone, New York, licensed in New York (015323) and active in the NPI registry since July 2021. She has opted out of Medicare through December 23, 2027, maintains a secondary practice location in Plattsburgh, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1093387797
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMISS JESSICA BRYNN SUPHAN
Location Address31 6TH STMalone, NY 12953-1246
Mailing Address102 Court St Apt 302Plattsburgh, NY 12901-2815 · (315) 591-6467
Phone(518) 483-3261
Fax(518) 483-3383
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 13, 2021
Last NPPES UpdateNovember 15, 20242 updates tracked since enumeration
NPPES CertifiedNovember 15, 2024
✔ NPI 1093387797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 015323
31 6TH ST, Malone, NY 12953
Open in Google Maps ↗

Secondary Practice Location 1

Location 18 Tara LnPlattsburgh, NY 12901-7224 · Phone (518) 324-7131

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Miss Jessica Brynn Suphan has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 23, 2025 through December 23, 2027.

Opt-Out Effective DateDecember 23, 2025
Opt-Out In Effect ThroughDecember 23, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH ELIZABETH BROWN BSW
Social Worker
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
KRISTEN MEEK
Counselor (Mental Health)
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
BROOKE DESAUTELS
Student in an Organized Health Care Education/Training Program
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
ANNEASHIA COLLINS PRS/PSR
Case Manager/Care Coordinator
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
DEANNA MARIE KIRKEY
Counselor (Addiction (Substance Use Disorder))
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
MARY ELIZABETH WHITE
Case Manager/Care Coordinator
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
ALLISON SOULIER
Case Manager/Care Coordinator
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261
KIERSTYN NICOLE NEWARA
Case Manager/Care Coordinator
31 6TH ST
MALONE, NY 12953
Franklin County (518) 483-3261

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Suphan's NPI number?

The NPI number for Jessica Suphan is 1093387797. It was assigned to this individual provider in the NPPES registry on July 13, 2021.

Where is Jessica Suphan located?

Jessica Suphan practices at 31 6th St, Malone, NY 12953. The listed phone number is (518) 483-3261.

What is Jessica Suphan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jessica Suphan enrolled in Medicare?

No. Jessica Suphan has opted out of Medicare through December 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jessica Suphan was last updated on November 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.