Jeremy Shane Van Tassel, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

306946 Issued in MN

Practice address

1112 7TH St NW
Rochester, MN 55901-1732

Phone

(507) 289-2089

NPI assigned

Feb 15, 2024

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Zumbro Valley Health Center

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1801961263
  NPD (past)

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1265297501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046242",
            "telephone_number": "507-289-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 7TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011732",
            "telephone_number": "507-289-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSEL",
        "first_name": "JEREMY",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Van Keulen
• Ross B Van Natta, MSPT
• Emma Rose Van Reysen, PHARMD, MBA
• Andrew Dean Van Ruler, MS, LPCC, LADC
• Velvet Van Ryan, APRN-CNP
• Benjamin Van Treeck, M.D.
• Jo Trunta Van Winter, M.D.
• Martin Van Zyl, MB BCH BAO
• Wendaline Marie Vanburen, MD
• Dorothy J Vanbuskirk, NP

• Addiction (Substance Use Disorder) Counselor in Rochester, MN
• Providers in Rochester, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.