Jill Carlson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

586 Issued in MN

Practice address

14300 Nicollet CT Ste 130
Burnsville, MN 55306-3422

Phone

(651) 286-8527

Fax

(651) 647-1861

NPI assigned

Apr 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Center for Personal and Family Development, P.a.Group PAC ID 3173436185, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Midwest Center for Personal & Family Development PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1285730903
  Medicare reassignment Care Compare group NPD
• Pathway Virtu-Health

  • Family Nurse Practitioner
  • Shoreview, MN
  • NPI 1073134284
  NPD (past)

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1831509850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 NICOLLET CT STE 130",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553063422",
            "telephone_number": "651-286-8527",
            "fax_number": "651-647-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 NICOLLET CT STE 130",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553063422",
            "telephone_number": "651-286-8527",
            "fax_number": "651-647-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carenest Solution LLC
• Caring Hands Autism Center LLC
• Caring Hearts Services LLC
• Marielyn Carino
• Laura G Carlisle, PHARM.D
• Keith Harold Carlson, M.D.
• Kelly Marie Carlson, CCC-SLP
• Valerie Rosabel Carlson, FINN
• Brynn Taylor Carlton
• Emma Christine Carpenter

• Mental Health Counselor in Burnsville, MN
• Providers in Burnsville, 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 Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.