Active NPI
Jennifer Joann Gregoire, LICSW
- Mental Health Counselor
- Marshall, MN
National Provider Identifier
1609167774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 17355
- Practice address
- 1400 E Lyon St
Marshall, MN 56258-2502 - Phone
- (507) 537-7899
- Fax
- (507) 537-7950
- NPI assigned
- Apr 25, 2011
- Last updated
- Apr 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 17355 | MN | Primary |
| Professional Counselor | 101YP2500X | 17355 | MN |
Addresses
Primary practice location
1400 E Lyon St
Marshall, MN 56258-2502
Mailing address
1400 E Lyon St
Marshall, MN 56258-2502
Phone (507) 537-7899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17355 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Minnesota Adult Mental Health Consortium | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Buffalo Ridge Assertive Community Treatment
- Mental Health Counselor
- Marshall, MN
- NPI 1447372933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303689600000",
"number": "1609167774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E LYON ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562582502",
"telephone_number": "507-537-7899",
"fax_number": "507-537-7950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E LYON ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562582502",
"telephone_number": "507-537-7899",
"fax_number": "507-537-7950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGOIRE",
"first_name": "JENNIFER",
"middle_name": "JOANN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-25",
"last_updated": "2011-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "17355",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "17355",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.