Heather Sarita Jackowell, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2079 Issued in MN

Practice address

44 Good Counsel Dr
Mankato, MN 56001-6599

Phone

(800) 438-1772

Fax

(262) 345-5562

NPI assigned

Nov 9, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Heather S Cameron Other name

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wisconsin Lutheran Child and Family Service IncGroup PAC ID 0749233898, 35 clinicians

Practice addresses (Care Compare)

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.

• Wisconsin Lutheran Child and Family Service Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628

  MN, Professional

  Medicare reassignment Care Compare group NPD
• Wisconsin Lutheran Child & Family Service, Inc.

  • Psychologist
  • Lakeville, MN
  • NPI 1396002630

  Professional

  NPD
• Freedom Counseling Center MN

  • Psychologist
  • Mankato, MN
  • NPI 1467964031
  NPD (past)
• Wisconsin Lutheran Child & Family Service

  • Psychologist
  • Mankato, MN
  • NPI 1801271515

  Professional

  NPD (past)
• Wisconsin Lutheran Child & Family Service ,Inc.

  • Adult Mental Health Clinic/Center
  • Milwaukee, WI
  • NPI 1548866528
  NPD (past)

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1467965624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224799",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 GOOD COUNSEL DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016599",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 South Ave",
            "address_purpose": "LOCATION",
            "city": "North Mankato",
            "state": "MN",
            "postal_code": "560033507",
            "country_code": "US",
            "telephone_number": "507-934-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKOWELL",
        "first_name": "HEATHER",
        "middle_name": "SARITA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CAMERON",
            "middle_name": "S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kenneth Ildefonso Jr., A.T.R
• Iowa Hearing Associates LLC
• Mohammad Saiful Islam, DDS PHD
• Nataline Ismail
• Ahmed Issa, MD
• Dylan Jacob Jackson
• Jenna Jackson, PHARM.D., R.PH.
• Marley Jackson
• Michael Jackson, OD
• Benjamin Jacobi, PHARM.D.

• Professional Counselor in Mankato, MN
• Providers in Mankato, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.