NPIMap

Organization Active NPI

Jennie Yngsdahl , Ma, Licensed Psychologist, LLC

Doing business as Center for Counseling and Wellness

  • Community/Behavioral Health Agency
  • Saint Paul, MN
National Provider Identifier
1417233701
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LP 4935 Issued in MN
Legal business name
JENNIE YNGSDAHL , MA, LICENSED PSYCHOLOGIST, LLC
Doing business as
Center for Counseling and Wellness
Practice address
333 Grand Ave Ste 205
Saint Paul, MN 55102-2583
Phone
(651) 294-2307
Fax
(651) 233-5641
NPI assigned
Oct 31, 2011
Last updated
Oct 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Jennie YngsdahlNPI 1194821777
Title
Licensed Psychologist
Phone
(651) 294-2307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LP 4935 MN Primary

Addresses

Primary practice location

333 Grand Ave Ste 205
Saint Paul, MN 55102-2583

Mailing address

333 Grand Ave Ste 205
Saint Paul, MN 55102-2583
Phone (651) 294-2307

Other names 1

  • Center for Counseling and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240312003031 MN Part B Supplier - Clinic/Group Practice 1759727787 Receives reassigned benefits from 6 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1417233701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GRAND AVE STE 205",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022583",
            "telephone_number": "651-294-2307",
            "fax_number": "651-233-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GRAND AVE STE 205",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022583",
            "telephone_number": "651-294-2307",
            "fax_number": "651-233-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIE YNGSDAHL , MA, LICENSED PSYCHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "YNGSDAHL",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-294-2307"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP 4935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.