Sequel Mental Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SEQUEL MENTAL HEALTH LLC

Practice address

19377 Upland St NW
Elk River, MN 55330-4140

Phone

(612) 237-7341

Fax

(612) 465-3032

NPI assigned

May 19, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Jenny M Klutch, LPCC

Title

Owner

Phone

(612) 237-7341

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Klutch, MA, LPCC

  • Professional Counselor
  • Otsego, MN
  • NPI 1245520048
  Medicare reassignment NPD

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1780321802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19377 UPLAND ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304140",
            "telephone_number": "612-237-7341",
            "fax_number": "612-465-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19377 UPLAND ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304140",
            "telephone_number": "612-237-7341",
            "fax_number": "612-465-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "KLUTCH",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-237-7341",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sherburne County (Sherburne County Health & Human Services)
• Sherburne County (Sherburne County HHS/Public Health Division)
• Sherburne County Social Services

• Mental Health Counselor in Elk River, MN
• Providers in Elk River, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.