Jill Marie Staloch, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

209 Issued in MN

Practice address

6245 W 214TH St
Jordan, MN 55352-8646

Phone

(612) 743-4663

NPI assigned

Dec 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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, 2005

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Mental Health, MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1265677256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 W 214TH ST",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553528646",
            "telephone_number": "612-743-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 W 214TH ST",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553528646",
            "telephone_number": "612-743-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALOCH",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "137856",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "209",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "12241-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karis Rygg, LAC
• Lydia Schmidt, D.C.
• Ashtyn Silva, CPM, LTM
• Susan Leigh Smith Brunes
• St Francis Regional Medical Center
• Elizabeth M. Thelemann-Zuniga, D.D.S.
• Total Health Advantage
• Heidi Marie Pahl Tousignant, M.A., CCC-SLP
• Cathy Jo Turner, LMFT
• Tyler Daniel Ukkelberg, DC

• All providers in Jordan, MN
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.