Justine Morgan Otremba, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC03638 Issued in MN

Practice address

301 Main St E
New Prague, MN 56071-1803

Phone

(507) 301-3412

NPI assigned

Jan 4, 2023

Last updated

Jan 4, 2023By the provider in NPPES

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

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairweather Investments, LLCGroup PAC ID 8123550829, 7 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairweather Investments, LLC

  dba Lakeville Behavioral Health

  • Mental Health Counselor
  • Lakeville, MN
  • NPI 1982238770
  Medicare reassignment Care Compare group NPD
• Secure Base Counseling Center LLC

  • Psychologist
  • Northfield, MN
  • NPI 1285905885
  NPD
• Lakeville Behavioral Health, LLC

  • Cognitive & Behavioral Psychologist
  • Lakeville, MN
  • NPI 1750412680
  NPD (past)

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1487367538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST E",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711803",
            "telephone_number": "507-301-3412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "MN",
            "postal_code": "550572756",
            "country_code": "US",
            "telephone_number": "507-242-3096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTREMBA",
        "first_name": "JUSTINE",
        "middle_name": "MORGAN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick O'Rourke, MD
• Timothy Olson, PHARM.D.
• Omega Medical Supply, LLC
• Optimal Sports Physical Therapy,LLC
• Jolene Otremba, D.C.
• P & J Holdings, Inc (Erickson Family Chiropractic)
• Barrett Richard Park, MD
• Dipenkumar Patel, RPH
• Kimberly R Penkert, ATC
• Praha Village LLC

• Mental Health Counselor in New Prague, MN
• Providers in New Prague, 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 Jan 4, 2023; 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.