Jill Salo, MS, LADC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3974 Issued in MN

Practice address

12400 Whitewater Dr Ste 140
Minnetonka, MN 55343-4168

Phone

(952) 479-0640

NPI assigned

Aug 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jill Van Otterloo Former name

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Aurora Lake Mental Health PLLC

  • Mental Health Counselor
  • Wayzata, MN
  • NPI 1871467290
  Medicare reassignment NPD Authorized official
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1619650744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 WHITEWATER DR STE 140",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434168",
            "telephone_number": "952-479-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 WHITEWATER DR STE 140",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434168",
            "telephone_number": "952-479-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALO",
        "first_name": "JILL",
        "credential": "MS, LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305949",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "VAN OTTERLOO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abdulrahman Sahli
• Laura Shrager Saliterman, M.D.
• Susan Hutcheson Salley, CRNP
• Kimberly Ann Salmela
• Janet Lynn Salmon, DNP FNP-BC ARNP RN
• Ashaunte Marie Salone, RBT
• Renee Saltness
• Nirmal K Samanta, PHD, CCC-SLP
• Ali Riza Samikoglu, M.D.
• Thomas W Samuelson, M.D.

• Mental Health Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.