Jennifer L Chellevold, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

637-226 Issued in WI

Practice address

17 S River St
254
Janesville, WI 53548-3860

Phone

(608) 755-5260

Fax

(608) 755-5267

NPI assigned

Mar 29, 2011

Sex

Female

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

Enrolled in WI

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Trivium LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1265450753
  NPD (past)
• Trivium LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Sun Prairie, WI
  • NPI 1427463066
  NPD (past)

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1699064808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST",
            "address_2": "254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483860",
            "telephone_number": "608-755-5260",
            "fax_number": "608-755-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST",
            "address_2": "254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483860",
            "telephone_number": "608-755-5260",
            "fax_number": "608-755-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELLEVOLD",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "637-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna Teja Challa, MD
• Benjamin Chao, D.O.
• George Charnecki, M.D.
• Eduardo Roberto Chavez Ruiz, M.D.
• Katlin Elizabeth Cheatham, APRN
• Chijen Lee Chen, M.D.
• Emma Cheung, MD
• Ananthakrishna Chilukuri, M.D.
• Karuna Chilukuri, M.D.
• Chiropractic Wellness Center, LTD.

• Mental Health Counselor in Janesville, WI
• Providers in Janesville, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.