Individual provider Active NPI

Jennifer Ann Stubblefield

  • Professional Counselor
  • Stillwater, MN
National Provider Identifier
1801389382
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3828 Issued in MN
Practice address
14949 62ND St N
Stillwater, MN 55082-6102
Phone
(651) 430-6483
NPI assigned
Jun 11, 2018
Reactivated
Sep 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 304423 MN
Professional Counselor 101YP2500X 3828 MN Primary

Addresses

Primary practice location

14949 62ND St N
Stillwater, MN 55082-6102

Mailing address

14949 62ND St N
Stillwater, MN 55082-6102
Phone (651) 430-6483

Other names 1

  • Jennifer Olander Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240118004457 MN Practitioner - Mental Health Counselor 9335591916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304423MNMDAddiction (Substance Use Disorder) Counselor
3828MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Threads of Hope Counseling, LLC Professional CurrentSince May 10, 2024 Accepting new patients

Locations

3460 Washington Dr
Ste 109
Saint Paul, MN 55122
Phone (612) 440-2678

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1801389382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826102",
            "telephone_number": "651-430-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826102",
            "telephone_number": "651-430-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBLEFIELD",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "deactivation_date": "2020-03-31",
        "reactivation_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304423",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "OLANDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.