NPIMap

Organization Active NPI

Jean M Bjerke, PA

  • Clinical Social Worker
  • Waite Park, MN
National Provider Identifier
1083846547
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8026 Issued in MN
Legal business name
JEAN M BJERKE, PA
Doing business as
Market Place Counseling
Practice address
110 2ND St S
Suite 303
Waite Park, MN 56387-1662
Phone
(320) 253-4080
Fax
(320) 253-4088
NPI assigned
Aug 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Jean M Bjerke, MA, LICSW
Title
Psychotherapist
Phone
(320) 253-4080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 8026 MN Primary

Addresses

Primary practice location

110 2ND St S
Suite 303
Waite Park, MN 56387-1662

Mailing address

110 2ND St S
Suite 303
Waite Park, MN 56387-1662
Phone (320) 253-4080

Other names 1

  • Market Place Counseling Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1083846547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 2ND ST S",
            "address_2": "SUITE 303",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871662",
            "telephone_number": "320-253-4080",
            "fax_number": "320-253-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST S",
            "address_2": "SUITE 303",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871662",
            "telephone_number": "320-253-4080",
            "fax_number": "320-253-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN M BJERKE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "BJERKE",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "320-253-4080",
        "authorized_official_credential": "MA, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "8026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Market Place Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.