Jennifer Noteboom, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC20549 Issued in SD

Practice address

111 Washington Ave NW
Wagner, SD 57380-4300

Phone

(605) 384-4861

Fax

(605) 384-4872

NPI assigned

Feb 18, 2022

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 TX

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wagner Indian Health Service Health CenterGroup PAC ID 6305758483, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Wagner Indian Health Service Health Center

  • Clinic/Center
  • Wagner, SD
  • NPI 1326066796

  TX

  Medicare reassignment Care Compare group NPD
• Empowering You Counseling and Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pickstown, SD
  • NPI 1043167356
  NPD Authorized official

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1215682133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WASHINGTON AVE NW",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573804300",
            "telephone_number": "605-384-4861",
            "fax_number": "605-384-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WASHINGTON AVE NW",
            "city": "WAGNER",
            "state": "SD",
            "postal_code": "573804300",
            "telephone_number": "605-384-4861",
            "fax_number": "605-384-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTEBOOM",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPC20549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarod Myer, FNP-C
• Lindsey Nedved, NP-C
• Cassie Lynn Nelson, CNP
• Amanda Neyhart, PHARMD
• Craig A Noteboom
• Lynn Ann Novak, MLT ASCP
• Michelle Olson, PA-C
• Melody Otte
• Rishi Patel, M.D.
• Colleen R Permann

• Professional Counselor in Wagner, SD
• Providers in Wagner, SD by specialty
• Professional Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.