Jamie Pendelton

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33097 Issued in MN

Practice address

205 14TH Ave E
Sartell, MN 56377-4500

Phone

(320) 774-3915

NPI assigned

May 21, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Northway Academy, Inc.

  • Developmental Disabilities Clinic/Center
  • Saint Cloud, MN
  • NPI 1104333715
  NPD (past)
• Northway Academy, Inc.

  • Community/Behavioral Health Agency
  • Sartell, MN
  • NPI 1841852639
  NPD (past)

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1649837121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEHLER DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774407",
            "telephone_number": "320-253-3512",
            "fax_number": "320-253-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 14TH AVE E",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774500",
            "telephone_number": "320-774-3915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Doctors Park",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031207",
            "country_code": "US",
            "telephone_number": "320-774-3915",
            "fax_number": "320-774-3918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDELTON",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "33097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayla M Pearson
• Clare Elizabeth Pederson
• Pediatric Dentistry P.C.
• Pediatric Dentistry P.L.C.
• Jordan Pellegrom, D.D.S.
• Kelli Jean Penrose, P.A., ATC
• Izabella Lou Peplinski
• Bryan Gary Perkins, M.D.
• Torilyn Mae Person
• Persona Dental P.C.

• Social Worker in Sartell, MN
• Providers in Sartell, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.