Coreen Tracee Jander, MA (LPCC-TX)

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

63182 Issued in TX

Practice address

1107 Hazeltine Blvd Ste 370
Chaska, MN 55318-1009

Phone

(952) 395-1441

Fax

(952) 395-1442

NPI assigned

Mar 29, 2022

Last updated

Mar 29, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1184364234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 HAZELTINE BLVD STE 370",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181009",
            "telephone_number": "952-395-1441",
            "fax_number": "952-395-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 HAZELTINE BLVD STE 370",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181009",
            "telephone_number": "952-395-1441",
            "fax_number": "952-395-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDER",
        "first_name": "COREEN",
        "middle_name": "TRACEE",
        "credential": "MA (LPCC-TX)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite Health Collaborative, PA
• Inmind Health, LLC
• Lynne W. Jackson, OTR
• Mara Ann Klipfel Jackson, PA-C, ATC
• James P Wire MD PA
• Cari Ann Jankowski, OTR.L
• Mariah Marie Jaus, DNP, CNP, FNP-C
• Dylan Ray Jenkins, DC
• Madaline Jennings, DC
• Kirsten Lee Johnson, RN, PHN, CDE

• Professional Counselor in Chaska, MN
• Providers in Chaska, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.