Individual provider Active NPI

Jennifer Nowak, LPCC

  • Professional Counselor
  • Stillwater, MN
National Provider Identifier
1497229637
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC02021 Issued in MN
Practice address
1875 Northwestern Ave S
Stillwater, MN 55082-7534
Phone
(651) 439-4840
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC02021 MN Primary

Addresses

Primary practice location

1875 Northwestern Ave S
Stillwater, MN 55082-7534

Mailing address

1875 Northwestern Ave S
Stillwater, MN 55082-7534
Phone (651) 439-4840

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240308002742 MN Practitioner - Mental Health Counselor 5991141202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthwise Psychology PAGroup PAC ID 2567685647, 32 clinicians

Practice addresses (Care Compare)

11280 86TH Ave N
Maple Grove, MN 55369-4510
Phone (763) 400-7828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC02021MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Scott M Yarosh, LLC CurrentSince Jan 1, 2024 Accepting new patients
Healthwise Psychology, PA CurrentSince Jan 1, 2024 Accepting new patients
Familymeans PastSince Aug 28, 1990 Accepting new patients

Locations

11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1497229637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-439-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-439-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "JENNIFER",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.