Jamie Michael Mersola

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

XXXXXXXXXXXXXXX Issued in MN

Practice address

9245 Quantrelle Ave NE
Otsego, MN 55330-0168

Phone

(763) 746-9492

NPI assigned

May 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

  dba Sagent Behavioral Health

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

  dba Sagent Behavioral Health

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

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1669118360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "818-391-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168",
            "telephone_number": "763-746-9492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11660 Round Lake Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332638",
            "country_code": "US",
            "telephone_number": "763-767-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERSOLA",
        "first_name": "JAMIE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "XXXXXXXXXXXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Louise McChesney, NP
• Medifit Health, LLC
• Christine Meierhofer
• Ann Clare Melde-Rahe, M.S, LPCC
• Marcus Piers Mensahn
• Sierra Miks
• Ashley Miller
• Joyce Miller
• Mind Body Mirror LLC
• Minnesota Dental Implants (MN Center for Dental Care)

• Clinical Psychologist in Otsego, MN
• Providers in Otsego, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.