Jessica Wellnitz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4140 Richard Ave Ste 200&300
Hermantown, MN 55811-2869

Phone

(218) 514-5230

NPI assigned

May 15, 2022

Last updated

May 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1184361842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N 14TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 RICHARD AVE STE 200&300",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112869",
            "telephone_number": "218-514-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLNITZ",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-15",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://caravelautism.com",
            "affiliation": "N",
            "address_1": "4140 Richard Ave Ste 200&300",
            "city": "Hermantown",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558112869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Technician in Hermantown, MN
• Providers in Hermantown, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2022; 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.