Organization Active NPI

Jennifer Kruse, M.a., LMHC, PLLC

  • Mental Health Counselor
  • Adel, IA
National Provider Identifier
1427328772
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00861 Issued in IA
Legal business name
JENNIFER KRUSE, M.A., LMHC, PLLC
Practice address
309 S 7TH St
Suite C
Adel, IA 50003-1838
Phone
(515) 993-1919
NPI assigned
Jan 4, 2012
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Jennifer Kruse, LMHC
Title
Owner/Therapist
Phone
(515) 402-8098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 00861 IA Primary

Addresses

Primary practice location

309 S 7TH St
Suite C
Adel, IA 50003-1838

Mailing address

309 S. 7TH St.
Suite C
Adel, IA 50003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240223002068 IA Part B Supplier - Clinic/Group Practice 5092150581 Receives reassigned benefits from 1 practitioner
Practice locations: Adel, IA

National Provider Directory

National Provider Directory

Locations

309 S 7th St
Ste C
Adel, IA 50003
Phone (515) 993-1919

Practitioners & affiliated clinicians

Practitioners 1

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": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1427328772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S. 7TH ST.",
            "address_2": "SUITE C",
            "city": "ADEL",
            "state": "IA",
            "postal_code": "50003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S 7TH ST",
            "address_2": "SUITE C",
            "city": "ADEL",
            "state": "IA",
            "postal_code": "500031838",
            "telephone_number": "515-993-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER KRUSE, M.A., LMHC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "515-402-8098",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adel, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.