Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Jessica Brynn Suphan

Individual provider Mental Health Counselor · NPI 1093387797

Miss. Jessica Brynn Suphan is a Mental Health Counselor in Malone, New York. Qualified in 2021, 5 years ago. Works from 2 locations. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
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Practice location Address checks out

31 6th St
Malone, NY 12953-1246
Phone: (518) 483-3261
Fax: (518) 483-3383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8 Tara Ln, Plattsburgh, NY 12901-7224 — (518) 324-7131

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 015323 (NY)

Record details

NPI number1093387797
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 13, 2021
Last updated in NPPESNovember 15, 2024
Certification dateNovember 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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