Individual provider Active NPI

Jade Lynn Holewinski, LPCC

  • Professional Counselor
  • Winona, MN
National Provider Identifier
1003335696
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01968 Issued in MN
Practice address
420 E Sarnia St
Winona, MN 55987-6365
Phone
(507) 454-4341
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01968 MN Primary

Addresses

Primary practice location

420 E Sarnia St
Winona, MN 55987-6365

Mailing address

420 E Sarnia St
Winona, MN 55987-6365
Phone (507) 454-4341

Other names 1

  • Jade Lynn Dudzik Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402000428 WI Practitioner - Mental Health Counselor 8729426390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JB Behavioral Health, LLCGroup PAC ID 7113390972, 8 clinicians

Practice addresses (Care Compare)

301 N Broadway
Suite 110
De Pere, WI 54115-2571
Phone (920) 425-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC01968MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
JB Behavioral Health, LLC CurrentSince Mar 4, 2024 Accepting new patients

Locations

101 W Edison Ave
Ste 113
Appleton, WI 54915
Phone (920) 370-7167

301 N Broadway
Ste 110
De Pere, WI 54115
Phone (920) 338-2855

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1003335696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876365",
            "telephone_number": "507-454-4341",
            "fax_number": "507-453-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876365",
            "telephone_number": "507-454-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEWINSKI",
        "first_name": "JADE",
        "middle_name": "LYNN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "DUDZIK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.