Individual provider Active NPI

Jeannette C Verick, LMFT

  • Marriage & Family Therapist
  • Waite Park, MN
National Provider Identifier
1255388138
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1433 Issued in MN
Practice address
110 2ND St S Ste 301
Waite Park, MN 56387-1314
Phone
(320) 252-2976
Fax
(320) 656-1570
NPI assigned
May 27, 2006
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1433 MN Primary

Addresses

Primary practice location

110 2ND St S Ste 301
Waite Park, MN 56387-1314

Mailing address

110 2ND St S Ste 301
Waite Park, MN 56387-1314
Phone (320) 252-2976

Other identifiers 2

IdentifierTypeStateIssuer
HP60192OtherHEALTH PARTNERS
922241046262OtherPREFERRED ONE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240229000929 MN Practitioner - Marriage and Family Therapist 3173968138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Processus P.a.Group PAC ID 2860447604, 9 clinicians

Practice addresses (Care Compare)

110 2ND S St
Suite 301
Waite Park, MN 56387-1314
Phone (320) 252-2976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Processus P.a. CurrentSince Jan 16, 2024 Accepting new patients

Locations

110 2nd St S
Ste 301
Waite Park, MN 56387
Phone (320) 240-9595

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1255388138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 2ND ST S STE 301",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871314",
            "telephone_number": "320-252-2976",
            "fax_number": "320-656-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST S STE 301",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871314",
            "telephone_number": "320-252-2976",
            "fax_number": "320-656-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERICK",
        "first_name": "JEANNETTE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP60192",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "922241046262",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

Verify at the official NPI Registry.