Jennifer Rebecca Gifford, MS, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302760 Issued in MN

Practice address

115 Willow St W
Suite #1
Detroit Lakes, MN 56501-3922

Phone

(218) 844-5191

Fax

(218) 844-5193

NPI assigned

Nov 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1258761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1447588918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WILLOW ST W",
            "address_2": "SUITE #1",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013922",
            "telephone_number": "218-844-5191",
            "fax_number": "218-844-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WILLOW ST W",
            "address_2": "SUITE #1",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013922",
            "telephone_number": "218-844-5191",
            "fax_number": "218-844-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "MS, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-21",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302760",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MN",
            "license": "436787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith G Gaer, PA-C
• Kelly Jo Gag
• Gary a Matthys MD PLC
• Brian J Gatheridge, PHD
• Emmalee Gavle
• Samuel Dylan Gobel, LPCC
• Mitchell B Goldstein, MD
• Kayla Gordon
• Phebe Gordon, NPC
• Wendy Lynn Gordon, R.D., RDH

• Addiction (Substance Use Disorder) Counselor in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.