Jonathan S Mayer, MS LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02907 Issued in MN

Practice address

823 Maple St
Brainerd, MN 56401-3770

Phone

(218) 454-8001

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Northern Pines Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Falls, MN
  • NPI 1013904051
  NPD
• Northern Pines Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Brainerd, MN
  • NPI 1225168602
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1821211426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VINCENT ST S",
            "city": "PIERZ",
            "state": "MN",
            "postal_code": "563644125",
            "telephone_number": "715-501-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 MAPLE ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013770",
            "telephone_number": "218-454-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Polk County Plz",
            "address_2": "Suite 50",
            "address_purpose": "LOCATION",
            "city": "Balsam Lake",
            "state": "WI",
            "postal_code": "548109071",
            "country_code": "US",
            "telephone_number": "715-485-8883",
            "fax_number": "715-485-8490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYER",
        "first_name": "JONATHAN",
        "middle_name": "S",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3706 125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41002300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS INSURANCE",
            "identifier": "HP75214",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Mason, MSW, LICSW
• Holley J. Mathieu, M.S.
• Susan Mary Mathison-Young, NURSE PRACTITIONER
• Jeffrey J Mattson, DDS
• Ted Matzen, M.D.
• Kendra Dee McAlpine
• Tara McCapes, MASSAGE THERAPIST
• Jaiden Wentz McCormick, OT
• Paul Joseph McCormick
• Michael McDermott, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.