Jennifer L Carlson

Individual provider Active NPI Behavior Technician · Rogers, MN

NPI 1821781758 · NPPES record last updated May 26, 2023

Key facts

NPI
1821781758
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
14000 Northdale Blvd Ste a
Rogers, MN 55374-4663
Phone
(763) 428-2478
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Matters, Inc. Past
since May 28, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

14000 Northdale Blvd Ste a
Rogers, MN 55374-4663

Mailing address

14000 Northdale Blvd Ste a
Rogers, MN 55374-4663
Phone (763) 428-2478

Other providers in Rogers, MN

All providers in Rogers, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.