Jennifer Lynn Gatzke – Professional Counselor

Key facts

NPI: 1902228547
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 838-6-1-15-301 (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
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.

Beacon Wellness LLC Professional Counselor · Bismarck, ND · NPI 1073110383

Medicare reassignment NPD ND · PROFESSIONAL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in ND
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240223003347	ND	Practitioner - Mental Health Counselor	2769868215	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Master of Science

State licenses

License	State	Type	Specialty
1701	ND	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Beacon Wellness LLC	Professional	Current since Jan 1, 2024	Accepting new patients

Locations

4205 State St
Ste 5
Bismarck, ND 58503
Phone (701) 214-5530

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	1701	ND
Professional Counselor	101YP2500X	838-6-1-15-301	ND	Yes

Addresses

Primary practice location

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

Mailing address

1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1220
Phone (701) 328-8842

Other names

Jennifer Lynn Rennich Former name

Other providers in Bismarck, ND

All providers in Bismarck, ND · Professional Counselor in North Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.