Jamie Rose Bankers
Individual provider Active NPI Professional Counselor · Mora, MN
NPI 1992263784 · NPPES record last updated May 13, 2020
Key facts
- NPI
- 1992263784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2424
- Practice address
- 2031 Rowland Rd
Mora, MN 55051-7119 - Phone
- (320) 364-1314
- Fax
- (320) 364-1320
- NPI assigned
- Mar 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2259 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manes for Change LLC | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2259 | MN | |
| Professional Counselor | 101YP2500X | 2424 | Yes | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304934 | MN |
Addresses
Primary practice location
2031 Rowland Rd
Mora, MN 55051-7119
Mailing address
2031 Rowland Rd
Mora, MN 55051-7119
Phone (320) 364-1314
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jamie@recoveringhope.life | Direct |
Other providers in Mora, MN
- Abagail LM Anderson
- Ibkhan Ansine
- Kimberly Ann Apel
- Augustana Senior Development II
- Amber Axtell
- Samantha Lynn Bednar
- Glen Thomas Bellefeuille
- Benedictine Living Community of Mora
- Benedictine Living Community of Mora
- Benedictine Living Community of Mora
All providers in Mora, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2020. 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.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.