Stacia Jeppson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02209 Issued in MN

Practice address

3018 Lake Shore Dr
Minneapolis, MN 55416-4282

Phone

(320) 493-8522

NPI assigned

Oct 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• North Counseling, LLC

  • Clinical Social Worker
  • Mankato, MN
  • NPI 1972217636
  Medicare reassignment NPD

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1386048247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MURIEFIELD DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017568",
            "telephone_number": "320-493-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 LAKE SHORE DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164282",
            "telephone_number": "320-493-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPSON",
        "first_name": "STACIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "411946275",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Jensen, OT
• Shane Jensen
• Steven R Jensen, MD
• Erik Gerber Jenson, M.D.
• Jason Jeon, DMD
• Stacy Jepsen, APRN-CNS
• Kimberly Anne Jepson, NP
• Kate Jergensen
• Kassandra Jennelle Jeronimo, DC
• Matthew A Jerulle, CNP

• Professional Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.