Jennifer Marie Dudek, LPCIT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2882-226 Issued in WI

Practice address

N5367 Mayflower Rd
Shiocton, WI 54170-8934

Phone

(920) 986-3003

Fax

(920) 986-3004

NPI assigned

Feb 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, WI2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Therapy Group of Colorado, PC

  • Clinical Social Worker
  • Greenwood Village, CO
  • NPI 1972389963

  Mental Health

  Medicare reassignment NPD
• CCP Clinic, LLC

  • Clinical Psychologist
  • De Pere, WI
  • NPI 1396431714
  Medicare reassignment
• Mindful Therapy Group of Colorado, P.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
  • NPI 1023971041
  NPD

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1013375419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5367 MAYFLOWER RD",
            "city": "SHIOCTON",
            "state": "WI",
            "postal_code": "541708934",
            "telephone_number": "920-986-3003",
            "fax_number": "920-986-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N5367 MAYFLOWER RD",
            "city": "SHIOCTON",
            "state": "WI",
            "postal_code": "541708934",
            "telephone_number": "920-986-3003",
            "fax_number": "920-986-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LPCIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2882-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Catherine Butch, MS, OTR
• Chaps Academy, Inc
• Kayla Duenas, RN
• Brittany Lynn Louise Ellie
• Jolene Marie Garvey Pintar, DC
• Mary Margaret Gerndt, LPC
• Michele Glime, LPCT

• Mental Health Counselor in Shiocton, WI
• Providers in Shiocton, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.