Individual provider Active NPI

Jane F Wilka-Pauly, LADC, LPCC

  • Professional Counselor
  • Alexandria, MN
National Provider Identifier
1033466958
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
00893 Issued in MN
Practice address
720 34TH Ave East
Alexandria, MN 56308
Phone
(320) 762-2400
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302642 MN
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 00893 MN Primary

Addresses

Primary practice location

720 34TH Ave East
Alexandria, MN 56308

Mailing address

980 S Tower Rd
Fergus Falls, MN 56537-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20241105000782 MN Practitioner - Mental Health Counselor 3173056769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Mental Health Center IncGroup PAC ID 1759291891, 39 clinicians

Practice addresses (Care Compare)

702 34TH Ave E
Alexandria, MN 56308-1518
Phone (320) 762-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00893MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Mental Health Center, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Ark Counseling Addiction (Substance Use Disorder) Past Accepting new patients

Locations

702 34th Ave E
Alexandria, MN 56308
Phone (320) 762-2400

980 S Tower Rd
Fergus Falls, MN 56537
Phone (218) 736-6987

Organizations & group practices 2

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033466958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S TOWER RD",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565375505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 34TH AVE EAST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "56308",
            "telephone_number": "320-762-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKA-PAULY",
        "first_name": "JANE",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302642",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "00893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.