Individual provider Active NPI

Jennifer M. Bertsch, PSY.D.

  • Clinical Psychologist
  • Savage, MN
National Provider Identifier
1548411762
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4606 Issued in MN
Practice address
8640 Eagle Creek Pkwy
Savage, MN 55378-1284
Phone
(952) 220-3268
NPI assigned
Oct 7, 2008
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4606 MN Primary
Forensic Psychologist 103TF0200X LP4606 MN

Addresses

Primary practice location

8640 Eagle Creek Pkwy
Savage, MN 55378-1284

Mailing address

8640 Eagle Creek Cir
Savage, MN 55378-4400

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
I20090811000550 MN Practitioner - Clinical Psychologist 5294887659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Serenity Behavioral Health and Wellness, LLCGroup PAC ID 7810308517, 8 clinicians

Practice addresses (Care Compare)

6375 143Rd St W
Savage, MN 55378-2888
Phone (952) 592-2200

6375 W 143Rd St
Savage, MN 55378-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Behavioral Health & Wellness Center, PLLC Clinical CurrentSince Jul 1, 2009 Accepting new patients
Serenity Behavioral Health & Wellness LLC Clinical CurrentSince Jul 10, 2020 Accepting new patients

Locations

6375 W 143rd St
Savage, MN 55378
Phone (952) 592-2200

8600 Eagle Creek Pkwy
Savage, MN 55378
Phone (612) 730-5315

8640 Eagle Creek Cir
Savage, MN 55378
Phone (952) 746-7664

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1548411762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK PKWY",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553781284",
            "telephone_number": "952-220-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2021-01-11",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4606",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP4606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

Verify at the official NPI Registry.