Kelsey L Jezierski, MA LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2991 Issued in MN

Practice address

1121 Jackson St NE Ste 105
Minneapolis, MN 55413-1665

Phone

(612) 874-7063

NPI assigned

Apr 23, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Pivotal Process LLC

  • Mental Health Counselor
  • Farmington, MN
  • NPI 1598491151
  NPD Authorized official
• Care Clinics, LLC

  • Psychologist
  • St Louis Park, MN
  • NPI 1851716245
  NPD (past)

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1467940718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 JACKSON ST NE STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131665",
            "telephone_number": "612-874-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JACKSON ST NE STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131665",
            "telephone_number": "612-874-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZIERSKI",
        "first_name": "KELSEY",
        "middle_name": "L",
        "credential": "MA LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Jewison, RN
• Hareindra Rishi Jeyamohan, MD
• Abdullahi Jeylani
• Amal Abukar Jeylani
• Anisa A Jeylani
• Abhishek Jha, M.B.B.S.
• Gautam Gopalji Jha, MD
• Shrawan Kumar Jha
• Jenny Ji
• Mohamed Abdifatah Jibril

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.