Active NPI
Jean Kristine Sershen, L.P.C.
- Professional Counselor
- Saint Paul, MN
National Provider Identifier
1548436306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 00355
- Practice address
- 333 Smith Ave N
Saint Paul, MN 55102-2344 - Phone
- (651) 241-8961
- Fax
- (651) 241-7168
- NPI assigned
- May 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 00355 | MN | Primary |
Addresses
Primary practice location
333 Smith Ave N
Saint Paul, MN 55102-2344
Mailing address
795 Winslow Ave
Saint Paul, MN 55107-3331
Phone (651) 224-4430
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jsershen33507@excellian.direct.allina.com | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00355 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients |
Locations
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
280 Smith Ave N
Ste 450
Saint Paul, MN 55102
Phone (651) 241-5959
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
Interoperability endpoints
- jsershen33507@excellian.direct.allina.com
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.
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- NPI 1588929079
-
- Rheumatology Physician
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- NPI 1952146516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1548436306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 WINSLOW AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551073331",
"telephone_number": "651-224-4430",
"fax_number": "651-241-7168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 SMITH AVE N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551022344",
"telephone_number": "651-241-8961",
"fax_number": "651-241-7168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERSHEN",
"first_name": "JEAN",
"middle_name": "KRISTINE",
"name_prefix": "Ms.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "00355",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jsershen33507@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "333 Smith Ave N",
"city": "Saint Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551022344",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.