Jennifer R Petersen, LPCC is a medicare enrolled "Counselor - Professional" provider in Alpha, Minnesota. She graduated from healthcare school in 2020 and has 5 years of diverse experience with area of expertise as Mental Health Counselor. She is a member of the group practice Southwestern Mental Health Center Inc and her current practice location is
230 Knox St S, Alpha, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 407-9775.
Jennifer R Petersen is licensed to practice in North Carolina (license number 21522) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1144992520.
Healthcare Provider's Profile
| Full Name | Jennifer R Petersen |
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| Gender | Female |
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| Speciality | Mental Health Counselor |
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| Experience | 5 Years |
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| Location | 230 Knox St S, Alpha, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jennifer R Petersen graduated from medical school in 2020
NPI Data:
- NPI Number: 1144992520
- Provider Enumeration Date: 10/04/2021
- Last Update Date: 10/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 7810434578
- Enrollment ID: I20240731001868
Medical Identifiers
Medical identifiers for Jennifer R Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144992520 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | 21522 (North Carolina) | Primary |
| 101YP2500X | Counselor - Professional | 4424 (Minnesota) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Southwestern Mental Health Center Inc | 7012816812 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jennifer R Petersen allows following entities to bill medicare on her behalf.
| Entity Name | Southwestern Mental Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487654562
PECOS PAC ID: 7012816812
Enrollment ID: O20031231000148 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer R Petersen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jennifer R Petersen, LPCC
125 S Lindberg Ave,
Dunnell, MN 56127-4006
Ph: (612) 968-4725 | Jennifer R Petersen, LPCC
230 Knox St S,
Alpha, MN 56111-4006
Ph: (507) 407-9775 |
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