Jennifer Lane Gervais, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15252 Issued in MN

Practice address

7616 Currell Blvd
Suite 275
Woodbury, MN 55125-2290

Phone

(612) 859-9405

NPI assigned

Apr 6, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Aris Clinic PA

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1609978063
  NPD (past)
• Prairie St Johns

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1417901000
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1912969544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7616 CURRELL BLVD",
            "address_2": "SUITE 275",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252290",
            "telephone_number": "612-859-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 CURRELL BLVD",
            "address_2": "SUITE 275",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252290",
            "telephone_number": "612-859-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERVAIS",
        "first_name": "JENNIFER",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADI",
            "identifier": "136608400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136608400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla M Gerasimou, DPT
• Andrea M.T. Gerber, RN, CNP
• Gretchen Elaine Gerlich, APNP
• Rachel Marie Germscheid
• Jade Gervais
• Kathleen H Gesensway, MD
• Kemry Noel Gett, MSW, LCSW
• Leah B Ghali, LICSW
• Sarah Giacobbe
• Leah Lambert Giertych, DPT, PT

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.