Jenelle Peterson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2025 Coulter Blvd
Chanhassen, MN 55317-5302

Phone

(952) 522-3132

NPI assigned

May 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenelle Kleinke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Elevated Therapy Solutions

  • Mental Health Counselor
  • Eden Prairie, MN
  • NPI 1508678582
  NPD Authorized official

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1134655574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 COULTER BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553175302",
            "telephone_number": "952-522-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 COULTER BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553175302",
            "telephone_number": "952-522-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "KLEINKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tia Paulson, PHARMD
• PDR Chanhassen, LTD
• Stephen Hilding Pearson, M.D.
• James Ernest Peck, PH.
• Katherine B Perusse, DO
• PHS/Chanhassen,Inc.
• Katherine Stratton Posch, PSYD, LP
• Provax LLC
• Kathryn Puklich, DPT, PT
• Gail N Raether, D.D.S.

• Mental Health Counselor in Chanhassen, MN
• Providers in Chanhassen, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; 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.