Individual provider Active NPI

Jill Marie Schlegel

  • Addiction (Substance Use Disorder) Counselor
  • Maple Grove, MN
National Provider Identifier
1245978600
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
302782 Issued in MN
Practice address
13931 76TH Ave N
Maple Grove, MN 55311-2754
Phone
(320) 224-8843
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302782 MN Primary

Addresses

Primary practice location

13931 76TH Ave N
Maple Grove, MN 55311-2754

Mailing address

13931 76TH Ave N
Maple Grove, MN 55311-2754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
302782MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1245978600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13931 76TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13931 76TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112754",
            "telephone_number": "320-224-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLEGEL",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.