Individual provider Active NPI

Jennifer S Stefanovski, LPC

  • Mental Health Counselor
  • Muncie, IN
National Provider Identifier
1558739755
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005494A Issued in IN
Practice address
3301 W Purdue Ave
Muncie, IN 47304-6356
Phone
(765) 284-0043
Fax
(765) 284-4112
NPI assigned
Sep 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E1200662 OH
Mental Health Counselor 101YM0800X 39005494A IN Primary

Addresses

Primary practice location

3301 W Purdue Ave
Muncie, IN 47304-6356

Mailing address

3301 W Purdue Ave
Muncie, IN 47304-6356
Phone (765) 284-0043

Other names 1

  • Miss Jennifer S Kollman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250922000958 IN Practitioner - Mental Health Counselor 7416451430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3301 W Purdue Ave
Muncie, IN 47304-6356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39005494AINMDMental Health Counselor
E1200662OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Still Waters Holdings Mental Health CurrentSince Jul 14, 2025 Accepting new patients

Locations

3301 W Purdue Ave
Muncie, IN 47304
Phone (765) 284-0043

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": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1558739755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "765-284-0043",
            "fax_number": "765-284-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "765-284-0043",
            "fax_number": "765-284-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANOVSKI",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E1200662",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005494A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KOLLMAN",
            "middle_name": "S",
            "prefix": "MISS",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.