Jaclyn Amys, MS, LPCC
Individual provider Active NPI Mental Health Counselor · Chaska, MN
NPI 1811540503 · NPPES record last updated Jul 22, 2019
Key facts
- NPI
- 1811540503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CC02157 (MN)
- Practice address
- 111 Hundertmark Rd Ste 450
Chaska, MN 55318-1460 - Phone
- (952) 368-0450
- NPI assigned
- Jul 22, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC02157 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Know the Truth Ministries Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC02157 | MN | Yes |
Addresses
Primary practice location
111 Hundertmark Rd Ste 450
Chaska, MN 55318-1460
Mailing address
1704 Hickory Hill Dr
Eagan, MN 55122-2410
Phone (218) 393-1328
Other providers in Chaska, MN
- Stacey Allen
- Jennifer Allie
- Allina Health System
- Ambulatory Anesthesia Services, PLLC
- American Current Care of Minnesota PC
- Jesica Marie Anderson
- Julie Dzik Anderson
- Melea Rae Anderson
- Suzanne R. Anderson
- Andrew J Will MD PA
All providers in Chaska, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.