Jessie M Perkovich, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

682 Issued in MN

Practice address

3203 3Rd Ave W
Hibbing, MN 55746-2406

Phone

(182) 263-9237

Fax

(218) 262-3150

NPI assigned

Dec 9, 2013

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

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

Medicare enrollment (NPD)

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.

• Range Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Virginia, MN
  • NPI 1457452823
  Medicare reassignment NPD
• Range Mental Health Center Inc

  dba Range Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Hibbing, MN
  • NPI 1639232663
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1730510371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 1ST ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922528",
            "telephone_number": "218-749-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 3RD AVE W",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462406",
            "telephone_number": "182-263-9237",
            "fax_number": "218-262-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKOVICH",
        "first_name": "JESSIE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "682",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Pedersen
• Jerome Wayne Pedersen, DDS
• Nathan Pedersen, DDS
• David Perell, DDS
• Pamela Perell, DDS
• Cheryl Marie Perpich, NCTMB
• Stephanie Anne Peterson, PHARMD
• Craig M Petroske
• Jennifer Petroske, PHARMD
• Shannon Rose Petroske, NP

• Professional Counselor in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.