Individual provider Active NPI

Jordan Westergren

  • Mental Health Counselor
  • Anoka, MN
National Provider Identifier
1548960883
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1833 3Rd Ave
Anoka, MN 55303-2424
Phone
(612) 924-3807
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 00000 MN
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1833 3Rd Ave
Anoka, MN 55303-2424

Mailing address

1833 3Rd Ave
Anoka, MN 55303-2424
Phone (612) 924-3807

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
I20260617002842 MN Practitioner - Mental Health Counselor 3678045929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

9325 Upland LN N
Suite 210
Maple Grove, MN 55369-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1548960883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 3RD AVE",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032424",
            "telephone_number": "612-924-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 3RD AVE",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032424",
            "telephone_number": "612-924-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERGREN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "00000",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

Verify at the official NPI Registry.