Carissa Joyce White, MPS, LADC, MHP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

305579 Issued in MN

Practice address

2031 Rowland Rd
Mora, MN 55051-7119

Phone

(320) 364-1300

Fax

(651) 323-2558

NPI assigned

Feb 25, 2020

Last updated

Feb 25, 2020By 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 1

Addresses

Other names 1

• Carissa Joyce Jahnz Former name

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, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dignity Counseling PLLC

  • Adult Mental Health Clinic/Center
  • Cambridge, MN
  • NPI 1922964170
  Medicare reassignment NPD Authorized official
• Introspect Mental Health LLC

  • Mental Health Counselor
  • White Bear LK, MN
  • NPI 1184273666
  NPD

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1922632363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 ROWLAND RD",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550517119",
            "telephone_number": "320-364-1300",
            "fax_number": "651-323-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 ROWLAND RD",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550517119",
            "telephone_number": "320-364-1300",
            "fax_number": "651-323-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CARISSA",
        "middle_name": "JOYCE",
        "credential": "MPS, LADC, MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "JAHNZ",
            "middle_name": "JOYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Welia Health
• Welia Health
• Welia Health
• Welia Health
• Bethany Josine Werner, MS CCC SLP
• Wikelius Counseling & Supervision, Inc. (Ampersand Psychological Services)
• Darci Jean Wikelius, PSY.D., LP
• Larissa N Wilhelm, DC
• James Matthew Williams, DDS
• Wilson Ridge LLC

• Addiction (Substance Use Disorder) Counselor in Mora, MN
• Providers in Mora, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.