Individual provider Active NPI

Jennifer L Hodgson, M.ED., LPC

  • Professional Counselor
  • Superior, WI
National Provider Identifier
1578638201
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6790-125 Issued in WI
Practice address
2207 E 5TH St
Superior, WI 54880-3708
Phone
(218) 212-3435
Fax
(218) 234-2993
NPI assigned
Nov 21, 2006
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240208003397 WI Practitioner - Mental Health Counselor 1456794270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
6790-125WIMDProfessional Counselor

Practice roles

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

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1578638201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61320 W FORK RD",
            "city": "IRON RIVER",
            "state": "WI",
            "postal_code": "548472600",
            "telephone_number": "330-321-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803708",
            "telephone_number": "218-212-3435",
            "fax_number": "218-234-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6790-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

Verify at the official NPI Registry.