Jonelle Klemz, MSW, LICSW

Key facts

NPI

1427429596

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

2860 (MN)

Practice address

705 Hillside Ave SW
Pine City, MN 55063-1466

Phone

(320) 629-7600

Fax

(651) 925-0071

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 14, 2015.

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1427429596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RAILROAD ST SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631540",
            "telephone_number": "320-629-7600",
            "fax_number": "651-925-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HILLSIDE AVE SW",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631466",
            "telephone_number": "320-629-7600",
            "fax_number": "651-925-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMZ",
        "first_name": "JONELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "2860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine City, MN

• Jami Johnson, LICSW
• Jennifer L Johnson, PHARMD
• Katherine Elizabeth Johnson, MA, LP
• Angela Marie Kemen, MSW, LICSW
• Katie Janice Keran
• Donald J Kunze, GC
• Lynette Rae Kuzel
• Bethany Lake, LMFT
• Lakeside Medical Center, Inc
• Lakeside Medical Center, Inc.

All providers in Pine City, MN · Clinical Social Worker in Minnesota