Jennifer L Hodgson, M.ED., LPC

Individual provider Active NPI Professional Counselor · Superior, WI

NPI 1578638201 · NPPES record last updated Nov 14, 2024

Key facts

NPI
1578638201
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6790-125 (WI)
Practice address
2207 E 5TH St
Superior, WI 54880-3708
Phone
(218) 212-3435
Fax
(218) 234-2993
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2207 E 5TH St
Superior, WI 54880-3708
Phone (218) 409-8114

61320 W Fork Rd
Iron River, WI 54847-2600

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240208003397 WI Practitioner - Mental Health Counselor 1456794270 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
6790-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Hodgson Clinical Services LLC Professional Current
since Oct 23, 2024
Accepting new patients
Carina Barker Clinical Practice LLC Professional Current
since Jan 1, 2024
Accepting new patients

Locations

2207 E 5th St
Superior, WI 54880
Phone (218) 212-3435

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6790-125 WI Yes

Addresses

Primary practice location

2207 E 5TH St
Superior, WI 54880-3708

Mailing address

61320 W Fork Rd
Iron River, WI 54847-2600
Phone (330) 321-6489

Other providers in Superior, WI

All providers in Superior, WI · Professional Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.