Jessica Marie Waldemar

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

5026 Evergreen TRL
North Branch, MN 55056-5562

Phone

(651) 755-5979

NPI assigned

Apr 28, 2022

Last updated

May 2, 2022By the provider in NPPES

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

Other names 1

• Jessica Marie Venhuizen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1023753746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5026 EVERGREEN TRL",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550565562",
            "telephone_number": "651-755-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 EVERGREEN TRL",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550565562",
            "telephone_number": "651-755-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEMAR",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VENHUIZEN",
            "middle_name": "MARIE",
            "credential": "MA, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in North Branch, MN
• Providers in North Branch, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.