Jennifer L Pedersen-Coulter, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001154 Issued in IA

Practice address

1045 76TH St Unit 3025
West Des Moines, IA 50266-5913

Phone

(515) 218-8625

NPI assigned

Nov 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Pedersen Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Drake University College of Medicine, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Elevated Minds, LLC

  • Mental Health Counselor
  • West Des Moines, IA
  • NPI 1609737758
  Medicare reassignment NPD Authorized official
• Woodward Youth Corporation

  • Community/Behavioral Health Agency
  • Des Moines, IA
  • NPI 1740695170
  NPD (past)
• Woodward Youth Corporation

  • Community/Behavioral Health Agency
  • Urbandale, IA
  • NPI 1760855266
  NPD (past)

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1336653484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 76TH ST UNIT 3025",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665913",
            "telephone_number": "515-218-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 76TH ST UNIT 3025",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665913",
            "telephone_number": "515-218-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN-COULTER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PEDERSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas O Paulson, MD
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• Krista Davis Pearl, MSN, ARNP
• Matthew Pearson
• Krista Pederson, CADC
• Zachariah Stanley Pederson, D.O.
• Pediatric Dentistry of Central Iowa PLLC
• Pediatric Neurology Divine Solutions PLLC
• Janet Pedroza Ramos, LCSW

• Mental Health Counselor in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.