Katlyn Jo Jessen, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC01561 Issued in MN

Practice address

611 Broadway Ave Ste 100
Wabasha, MN 55981

Phone

(651) 565-2235

Fax

(651) 565-2890

NPI assigned

Jul 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  MN

  Medicare reassignment Care Compare group NPD
• Fernbrook Family Center, Inc

  • Social Worker
  • Owatonna, MN
  • NPI 1659483915
  NPD (past)

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates LTD 590 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1447772249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876442",
            "telephone_number": "507-454-4341",
            "fax_number": "507-205-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 BROADWAY AVE STE 100",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "55981",
            "telephone_number": "651-565-2235",
            "fax_number": "651-565-2890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 2nd St W",
            "address_purpose": "LOCATION",
            "city": "Wabasha",
            "state": "MN",
            "postal_code": "559811266",
            "country_code": "US",
            "telephone_number": "507-446-0431",
            "fax_number": "507-446-8014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "KATLYN",
        "middle_name": "JO",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Allen Hoffmann, D.C.
• Jennifer J Hust, NP
• John F Hust, RN, CRNA
• Lisa Mae Jaeger, LPC
• Kent Shepard Jeffery, MD
• JL Walsh PA
• Jonathan G. Peterson Psychiatry, LTD.
• Brian E. Kelly, MD
• Camilla Lynn Kohutko, PT
• Marlene Kosobucki, PT

• All providers in Wabasha, MN
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.