Jennifer Lynn Gatzke, MS, LAC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

838-6-1-15-301 Issued in ND

Practice address

1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1220

Phone

(701) 328-8842

Fax

(701) 328-8900

NPI assigned

Jan 16, 2014

Last updated

Jan 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Lynn Rennich Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Wellness LLC

  • Professional Counselor
  • Bismarck, ND
  • NPI 1073110383
  Medicare reassignment NPD

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1902228547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011220",
            "telephone_number": "701-328-8842",
            "fax_number": "701-328-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011220",
            "telephone_number": "701-328-8842",
            "fax_number": "701-328-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATZKE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MS, LAC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1701",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "838-6-1-15-301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RENNICH",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.