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JACQUELINE SURDAN LMHC
NPI 1902432396
Counselor - Mental Health in Waltham, MA

Active since March 17, 2020PECOS Enrolled
409 LEXINGTON ST, WALTHAM, MA 02452(781) 647-9976 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 24, 2024, Mar 17, 2020 (2 updates tracked since 2020).

About Jacqueline Surdan Lmhc NPPES

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

JACQUELINE SURDAN LMHC (NPI 1902432396) is an individual mental health provider in Waltham, Massachusetts, licensed in Massachusetts (LMHC10002078) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1902432396
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE SURDANCredential: LMHC
Location Address409 LEXINGTON STWaltham, MA 02452-0933
Mailing Address409 Lexington StWaltham, MA 02452-0933
Phone(781) 647-9976
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 17, 2020
Last NPPES UpdateJune 24, 20242 updates tracked since enumeration
NPPES CertifiedJune 24, 2024
✔ NPI 1902432396 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 MA · LMHC10002078
409 LEXINGTON ST, Waltham, MA 02452
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Surdan Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608389614
PECOS Enrollment IDI20250702001677
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Surdan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Center Psychotherapy LLC
6.7 mi
Mental Health
540 MAIN ST STE 14
Winchester, MA 01890
  • Reassigned Medicare billing, Massachusetts enrollment
  • 11 clinicians in this Medicare group
NPI 1962974949 (781) 720-8578

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

KARLIE LINA ASHCROFT OTR/L
Occupational Therapist (Mental Health)
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9956
SHAUNA CAFFREY LICSW
Social Worker
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (800) 529-5077
EMMA ELIZABETH SKINNER
Student in an Organized Health Care Education/Training Program
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976
KERRY LYNNE MOE LICSW
Social Worker (Clinical)
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976
CASEY WILLIAMSON
Student in an Organized Health Care Education/Training Program
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976
REBECCA DARRAH
Counselor (Mental Health)
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976
EMMA GOODREAU
Counselor
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976
JEFFREY BERRY
Social Worker (School)
409 LEXINGTON ST
WALTHAM, MA 02452
Middlesex County (781) 647-9976

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 Jacqueline Surdan's NPI number?

The NPI number for Jacqueline Surdan is 1902432396. It was assigned to this individual provider in the NPPES registry on March 17, 2020.

Where is Jacqueline Surdan located?

Jacqueline Surdan practices at 409 Lexington St, Waltham, MA 02452. The listed phone number is (781) 647-9976.

What is Jacqueline Surdan's specialty?

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

Is Jacqueline Surdan enrolled in Medicare?

Yes. Jacqueline Surdan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Surdan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Surdan reassigns Medicare benefits to Center Psychotherapy LLC (Winchester, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Surdan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacqueline Surdan accept?

Health plans from Harvard Pilgrim Health Care list Jacqueline Surdan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacqueline Surdan was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.