Jennifer Klutch, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00291 Issued in MN

Practice address

9075 Quaday Ave NE
Suite 102
Otsego, MN 55330-6672

Phone

(763) 746-9492

NPI assigned

Apr 13, 2011

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, 2009

Medicare assignment

May accept Medicare assignment

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 and National Provider Directory roles.

• Sequel Mental Health LLC

  • Mental Health Counselor
  • Elk River, MN
  • NPI 1780321802
  Medicare reassignment NPD
• DBT and Emdr Specialists, P.a.

  • Community/Behavioral Health Agency
  • Elk River, MN
  • NPI 1750774162
  NPD (past)
• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD (past)

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1245520048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 QUADAY AVE NE",
            "address_2": "SUITE 102",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306672",
            "telephone_number": "763-746-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTCH",
        "first_name": "JENNIFER",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedy Vision Health Center, LLC
• Heather A Kerfeld
• Jamie Ann Kienitz, RN
• Amy Lou Kimbler, MT-BC
• Johanna Kinser, OD
• Ann M Kooiker, MD
• Angela M Krats, MSW, LGSW
• Rachel Krautbauer, DPT
• Jennifer Krebs
• Kendra Kruger

• Professional Counselor in Otsego, MN
• Providers in Otsego, 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 10, 2015; 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.