Organization Active NPI

Tjzarn Ventures LLC

Doing business as Reflections Counseling of Northwest Wisconsin

  • Professional Counselor
  • Balsam Lake, WI
National Provider Identifier
1063278174
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
TJZARN VENTURES LLC
Doing business as
Reflections Counseling of Northwest Wisconsin
Practice address
215 Main St Ste 205
Balsam Lake, WI 54810-7264
Phone
(715) 256-7559
Fax
(877) 869-0712
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Becky Peterson
Title
Office Manager
Phone
(715) 256-7559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

215 Main St Ste 205
Balsam Lake, WI 54810-7264

Mailing address

PO Box 105
Balsam Lake, WI 54810-0105
Phone (715) 256-7559

Other names 1

  • Reflections Counseling of Northwest Wisconsin Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240725002180 WI Part B Supplier - Clinic/Group Practice 1355887373 Receives reassigned benefits from 1 practitioner
Practice locations: Balsam Lake, WI

National Provider Directory

National Provider Directory

Locations

215 Main St
Balsam Lake, WI 54810
Phone (715) 566-0762

215 Main St
Ste 205
Balsam Lake, WI 54810
Phone (715) 256-7559

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1063278174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548100105",
            "telephone_number": "715-256-7559",
            "fax_number": "877-869-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MAIN ST STE 205",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548107264",
            "telephone_number": "715-256-7559",
            "fax_number": "877-869-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJZARN VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-256-7559"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reflections Counseling of Northwest Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Balsam Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.