Jessica Waldemarsen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28179 Issued in MN

Practice address

217 Industrial Dr SW
Willmar, MN 56201-2989

Phone

(320) 212-8481

Fax

(320) 200-7480

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

Yes

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

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.

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nolan'S Place LLC

  • Behavior Technician
  • Willmar, MN
  • NPI 1154826469

  Clinical

  NPD (past)

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1679197602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562010200",
            "telephone_number": "320-212-8481",
            "fax_number": "320-200-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 INDUSTRIAL DR SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012989",
            "telephone_number": "320-212-8481",
            "fax_number": "320-200-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEMARSEN",
        "first_name": "JESSICA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Louise Vomacka, MD
• Gretchen Mary Vonrueden, DDS
• Lyndsie Jo Voorhees, LPCC
• Kathyrn Ann Wagner, LADC
• Wal-Mart Stores, Inc
• Walgreen Co
• Walmart Inc.
• Raquel Kay Walsh Jahnke, DO, MBA
• Cheryl Lee Walter, BS, LADC
• Emily Vonann Walter, LMFT

• Clinical Social Worker in Willmar, MN
• Providers in Willmar, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.