Jean Linda Udesen

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

1485 81St Avenue North East
Spring Lake Park, MN 55432

Phone

(763) 780-3036

Fax

(763) 780-0784

NPI assigned

Sep 13, 2007

Last updated

Sep 13, 2007By the provider in NPPES

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

• Miss Jean Linda Burkland Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1417142332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WINDSOR LANE",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-631-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 81ST AVENUE NORTH EAST",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "763-780-3036",
            "fax_number": "763-780-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDESEN",
        "first_name": "JEAN",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "BURKLAND",
            "middle_name": "LINDA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Summers, LADC
• Heather Elaine Swanson, M.D.
• Brady Harrison Thompson
• Antenalu Desta Tona
• Total Medical Supply Co Inc
• Trevor Velin, DC
• Vibrance Home Care LLC
• Wabo Alf LLC
• Junao Wang, M.D.
• Terrie Lee Vann Ward, NP

• Counseling Psychologist in Spring Lake Park, MN
• Providers in Spring Lake Park, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.