Active NPI
Jennifer Weigelt, LP
- Clinical Psychologist
- Otsego, MN
National Provider Identifier
1053690297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP6413
- Practice address
- 16201 90TH St NE
Otsego, MN 55330-7463 - Phone
- (612) 790-9141
- NPI assigned
- Aug 5, 2011
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP6413 | MN | Primary |
Addresses
Primary practice location
16201 90TH St NE
Otsego, MN 55330-7463
Mailing address
PO Box 64
Hamel, MN 55340-0064
Phone (612) 790-9141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00318 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacetree Family Institute LTD | Professional | Current | Accepting new patients |
Locations
11090 183rd Cir NW
Ste C
Elk River, MN 55330
Phone (763) 777-1381
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053690297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64",
"city": "HAMEL",
"state": "MN",
"postal_code": "553400064",
"telephone_number": "612-790-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16201 90TH ST NE",
"city": "OTSEGO",
"state": "MN",
"postal_code": "553307463",
"telephone_number": "612-790-9141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIGELT",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-05",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP6413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Otsego, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.