Individual provider Active NPI

Jessica Frances Pendal

  • Counselor
  • Minneapolis, MN
National Provider Identifier
1316637697
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
306217 Issued in MN
Practice address
7601 Wayzata Blvd
Minneapolis, MN 55426-1626
Phone
(612) 223-8898
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 306217 MN Primary

Addresses

Primary practice location

7601 Wayzata Blvd
Minneapolis, MN 55426-1626

Mailing address

7601 Wayzata Blvd
Minneapolis, MN 55426-1626

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
I20241107003279 MN Practitioner - Mental Health Counselor 1951835370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jennie Yngsdahl Ma Licensed Psychologist LLCGroup PAC ID 1759727787, 3 clinicians

Practice addresses (Care Compare)

333 Grand Ave
Suite 205
Saint Paul, MN 55102-2583
Phone (763) 567-3136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306217MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie Yngsdahl , Ma, Licensed Psychologist, LLC CurrentSince Oct 1, 2024 Accepting new patients
Seiler Creek Therapy LLC Current Accepting new patients

Locations

333 Grand Ave
Ste 205
Saint Paul, MN 55102
Phone (651) 294-2307

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1316637697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261626",
            "telephone_number": "612-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDAL",
        "first_name": "JESSICA",
        "middle_name": "FRANCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "306217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.