Individual provider Active NPI

Reagan Jane Quinn, LPC, LPCC

  • Professional Counselor
  • Willmar, MN
National Provider Identifier
1912137845
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC00175 Issued in MN
Practice address
1125 6TH St SE
Willmar, MN 56201-4675
Phone
(320) 979-7531
NPI assigned
Jul 27, 2009
Last updated
Aug 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 499-1-1-04-155 ND
Professional Counselor 101YP2500X CC00175 MN Primary

Addresses

Primary practice location

1125 6TH St SE
Willmar, MN 56201-4675

Mailing address

1125 6TH St SE
Willmar, MN 56201-4675
Phone (320) 979-7531

Other names 1

  • Reagan Jane Lorenz Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240923001578 MN Practitioner - Mental Health Counselor 7214478858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC00175MNMDProfessional Counselor
175MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Centers CurrentSince Jul 12, 2024 Accepting new patients

Locations

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

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

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1912137845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-979-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-979-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "REAGAN",
        "middle_name": "JANE",
        "credential": "LPC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "499-1-1-04-155",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REAGAN",
            "last_name": "LORENZ",
            "middle_name": "JANE",
            "credential": "LPC, LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.