Individual provider Active NPI

Jessica Lynn Paulsen, LMFT

  • Marriage & Family Therapist
  • Willmar, MN
National Provider Identifier
1275877185
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2137 Issued in MN
Practice address
513 5TH St SW
Willmar, MN 56201-3216
Phone
(320) 214-9692
Fax
(320) 214-9924
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 2137 MN Primary

Addresses

Primary practice location

513 5TH St SW
Willmar, MN 56201-3216

Mailing address

513 5TH St SW
PO Box 1810
Willmar, MN 56201-3216
Phone (320) 214-9692

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
I20260226002302 MN Practitioner - Marriage and Family Therapist 0042791147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 E College Dr
Suite 108
Marshall, MN 56258-1365

7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2137MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Intrepid Mental Health LLC CurrentSince Feb 1, 2024 Accepting new patients
Greater Minnesota Family Services PastSince Sep 6, 2020 Accepting new patients

Locations

200 E College Dr
Ste 108
Marshall, MN 56258
Phone (501) 591-0055

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1275877185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 5TH ST SW",
            "address_2": "PO BOX 1810",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013216",
            "telephone_number": "320-214-9692",
            "fax_number": "320-214-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 5TH ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013216",
            "telephone_number": "320-214-9692",
            "fax_number": "320-214-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.