Active NPI
Jennifer Ann Bertolatus, LPCC
- Counselor
- St. Paul, MN
National Provider Identifier
1235564352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CC00477
- Practice address
- 1585 Rice Street
St. Paul, MN 55117 - Phone
- (651) 487-8088
- Fax
- (651) 487-8105
- NPI assigned
- Sep 9, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CC00477 | MN | Primary |
Addresses
Primary practice location
1585 Rice Street
St. Paul, MN 55117
Mailing address
1585 Rice Street
St. Paul, MN 55117
Phone (651) 487-8088
Other names 1
- Ms. Jennifer Ann Rishavy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00477 | MN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1235564352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 RICE STREET",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55117",
"telephone_number": "651-487-8088",
"fax_number": "651-487-8105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 RICE STREET",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55117",
"telephone_number": "651-487-8088",
"fax_number": "651-487-8105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTOLATUS",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-09",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MN",
"license": "CC00477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "RISHAVY",
"middle_name": "ANN",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.