Active NPI
Jolene Anna Pundsack, MS, LPCC,
- Mental Health Counselor
- Alexandria, MN
National Provider Identifier
1215296892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC00476
- Practice address
- 324 Broadway St Ste 206
Alexandria, MN 56308-1482 - Phone
- (320) 762-1762
- Fax
- (320) 762-0796
- NPI assigned
- May 16, 2012
- Last updated
- Feb 9, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC00476 | MN | Primary |
Addresses
Primary practice location
324 Broadway St Ste 206
Alexandria, MN 56308-1482
Mailing address
324 Broadway St Ste 206
Alexandria, MN 56308-1482
Phone (320) 762-1762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 9, 2026 through Feb 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00476 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1215296892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 BROADWAY ST STE 206",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563081482",
"telephone_number": "320-762-1762",
"fax_number": "320-762-0796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 BROADWAY ST STE 206",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563081482",
"telephone_number": "320-762-1762",
"fax_number": "320-762-0796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUNDSACK",
"first_name": "JOLENE",
"middle_name": "ANNA",
"credential": "MS, LPCC,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-16",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC00476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.