Jessica Marie Mertz, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4490 Issued in ND

Practice address

7151 15TH St S
Fargo, ND 58104-6613

Phone

(701) 364-2950

Fax

(701) 364-2953

NPI assigned

Jan 11, 2012

Last updated

Oct 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jessica Marie Clausen Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

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.

• Dakota Family Services

  • Clinic/Center
  • Minot, ND
  • NPI 1114119989
  Medicare reassignment NPD
• Dakota Family Services

  dba Dakota Family Services Bismarck

  • Clinic/Center
  • Bismarck, ND
  • NPI 1184352734
  NPD
• Dakota Family Services

  • Clinic/Center
  • Fargo, ND
  • NPI 1578755344
  NPD
• Valley Christian Counseling Center Inc

  • Professional Counselor
  • Fargo, ND
  • NPI 1467559427

  Clinical

  NPD (past)
• Family Service Agency of Waukesha County Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukesha, WI
  • NPI 1568404671
  NPD (past)
• Family Services of Waukesha

  • Community/Behavioral Health Agency
  • Waukesha, WI
  • NPI 1265677884
  NPD (past)

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1548530280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 15TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046613",
            "telephone_number": "701-364-2950",
            "fax_number": "701-364-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 15TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046613",
            "telephone_number": "701-364-2950",
            "fax_number": "701-364-2953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 25th Ave N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581021938",
            "country_code": "US",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4490",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CLAUSEN",
            "middle_name": "MARIE",
            "credential": "M.A., MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meridian Chiropractic Clinic
• Meritcare Medical Group (MeritCare Dermatology & Laser Clinic)
• Emma Mertens, M.S., CF-SLP
• Jacob Mertens, PT, DPT
• Lauren Mertes, RN
• Morgan Brooke Mertz, RD
• Taylor Elizabeth Mertz, CNM
• Cory Richard Messer
• Shaunna Messmer-Lavalley, PT, DPT
• Amy Messner, LBSW

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.