JENNIFER R PETERSEN (LPCC) – Professional Counselor, NPI 1144992520

JENNIFER R PETERSEN (LPCC) is a healthcare provider. based in Fairmont, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC. They hold a License No. 4424 (MN). The NPI Number for JENNIFER R PETERSEN (LPCC) is 1144992520

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER R PETERSEN (LPCC)
NPI
1144992520
Phone
(507) 407-9775
Address
3400 Cedar Park Rd
Enumeration Date
4 October 2021
Last Update Date
16 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5072839511
Graduation Year
2020 (6 years ago)
PAC ID
7810434578
Group Practice PAC ID
7012816812
Professional Enrollment ID
I20240731001868
Address ID
MN561561916LU117XXSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:4State licenses:2Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for JENNIFER R PETERSEN (LPCC)

  • 3400 Cedar Park Rd

    Fairmont, MN 56031

    Phone: (507) 407-9775

    Type: Location

  • 1900 SILVER LAKE RD NW STE 110

    NEW BRIGHTON, MN 551121789

    Phone: (612) 968-4725

    Fax: (651) 628-0411

    Type: Mailing

  • 201 N BROAD ST STE 200

    MANKATO, MN 560013569

    Phone: (507) 200-2624

    Fax: (507) 225-1501

    Type: Location

  • 125 S LINDBERG AVE

    DUNNELL, MN 561274006

    Phone: (612) 968-4725

    Type: Mailing

  • 230 KNOX ST S

    ALPHA, MN 561114006

    Phone: (507) 407-9775

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240731001868IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012816812View full group profile
NameSpecialtyState
-MN
Mental Health CounselorMN
Clinical Social WorkerPA
-MN
Mental Health CounselorMN
Clinical Social WorkerLA
Mental Health CounselorMN
Clinical Social WorkerIA
-MN
Nurse PractitionerSD

Reviews

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Frequently asked questions

What is JENNIFER R PETERSEN (LPCC)'s NPI number?
JENNIFER R PETERSEN (LPCC)'s NPI is 1144992520 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to JENNIFER R PETERSEN (LPCC)?
You should see JENNIFER R PETERSEN (LPCC) as active in CMS-hosted NPPES data.
What area of care is associated with JENNIFER R PETERSEN (LPCC)?
JENNIFER R PETERSEN (LPCC)'s record emphasizes Professional Counselor. Clinical services aligned with this taxonomy classification.
Is JENNIFER R PETERSEN (LPCC) located near Fairmont?
JENNIFER R PETERSEN (LPCC) currently maps to Fairmont, Minnesota in this extract.
When was this NPI issued?
Enumeration for JENNIFER R PETERSEN (LPCC) is noted as October 4, 2021 where the registry provides it.

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