Jessica Watterud, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

228 Issued in ND

Practice address

17 S Main St
Crosby, ND 58730-5873

Phone

(701) 240-6971

Fax

(701) 965-3522

NPI assigned

Mar 27, 2012

Last updated

Aug 16, 2018By 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 2

Addresses

Other names 1

• Jessica Anderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Watterud Counseling and Consultation LLC

  • Mental Health Counselor
  • Crosby, ND
  • NPI 1285183400
  Authorized official Same address or phone
• Melissa Nystuen Counseling Services LLC

  • Community/Behavioral Health Agency
  • Crosby, ND
  • NPI 1467900209
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1114293941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 136",
            "city": "CROSBY",
            "state": "ND",
            "postal_code": "587300136",
            "telephone_number": "701-240-6971",
            "fax_number": "701-965-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S MAIN ST",
            "city": "CROSBY",
            "state": "ND",
            "postal_code": "587305873",
            "telephone_number": "701-240-6971",
            "fax_number": "701-965-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 Belsly Blvd",
            "address_purpose": "LOCATION",
            "city": "Moorhead",
            "state": "MN",
            "postal_code": "565605055",
            "country_code": "US",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTERUD",
        "first_name": "JESSICA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "228",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Crosby)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Crosby)
• Jessalyn Thomas
• Amber Lea Urvand, DPT
• Watterud Counseling and Consultation LLC
• Kami Vyjo Wehrman, D.C.
• Wildrose Public Transportation
• Lorieann Rose Wishart
• Angela Dawn Wood

• Mental Health Counselor in Crosby, ND
• Providers in Crosby, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.