Jillian Jae Ristau, MS, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2984 Issued in MN

Practice address

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Phone

(218) 326-1274

NPI assigned

Nov 5, 2015

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northland Counseling Center IncGroup PAC ID 1153389242, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Master of Science - Law

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.

• Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1164610986
  Medicare reassignment Care Compare group NPD
• Calla

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia, MN
  • NPI 1649791047
  NPD (past)
• Kind Mind Counseling Center

  • Community/Behavioral Health Agency
  • Hibbing, MN
  • NPI 1528327970
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1437522984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "KEEWATIN",
            "state": "MN",
            "postal_code": "557530636",
            "telephone_number": "218-244-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615",
            "telephone_number": "218-326-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "JILLIAN",
        "middle_name": "JAE",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01757",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather A. Rhodes, M.S.
• Richard a. Perrott OD PA
• Jessie Lind Richards
• John Riggs
• Michele Rinne, MS ED, LP
• Nicolette Ronaye Roberts
• Bridgitte Lee Rondeau, LADC
• Roots Chiropractic Center LLC
• Ross Resources LTD.
• Anthony N Ross, LGSW

• Professional Counselor in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.