Jennie Jean Pogreba, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14716 Issued in MN

Practice address

4154 Shoreline Dr
Spring Park, MN 55384-5606

Phone

(612) 567-0316

Fax

(952) 491-9460

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Empowering You Mental Health, P.L.L.C.

  • Clinical Social Worker
  • Wayzata, MN
  • NPI 1346025590
  NPD Authorized official

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1316649775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 DEERFIELD RD",
            "city": "WATERTOWN",
            "state": "MN",
            "postal_code": "553889275",
            "telephone_number": "952-807-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553845606",
            "telephone_number": "612-567-0316",
            "fax_number": "952-491-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGREBA",
        "first_name": "JENNIE",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Lee Olson, LPCC
• Kirsten Peckham, L.AC.
• Jerry R Petersen, MD
• PHS Lake Minnetonka LLC
• PHS/Lake Minnetonka, LLC
• Population Health Management PC
• Julie Marie Reineck, PHARMD
• Reuss Therapeutic Services
• Ridgeview Clinics (Western Orthopaedics & Sports Medicine Consultants)
• Ridgeview Clinics

• Clinical Social Worker in Spring Park, MN
• Providers in Spring Park, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.