JENNIFER L WILSON (NPI# 1124684600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124684600 |
| Entity Type | Individual |
| Full Name | JENNIFER L WILSON |
| Credential | PH.D. |
| Practice Address |
11010 Prairie Lakes Dr Ste 350 Eden Prairie MN 55344-3801 |
| Mailing Address |
1900 Silver Lake Rd Nw Ste 110 New Brighton MN 55112-1789 |
| Practice Telephone | 9527462522 |
| Mailing Telephone | 6516289566 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP5857 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112013 | Jennifer Rockell Wilson | Case Manager/Care Coordinator | 450 S Venoy Rd, Westland, MI 48186-7805 | 2020-04-08 |
| 1023577665 | Jennifer Marie Wilson | Social Worker | 9660 Bend Dr, Jenison, MI 49428-9525 | 2019-03-13 |
| 1720545049 | Jennifer M Wilson | Registered Nurse | 17 Ridge Ave, Spring Valley, NY 10977-5407 | 2019-02-22 |
| 1528533726 | Jennifer S. Wilson | Specialist/Technologist | 216 Cody Ct, Clarksville, TN 37043-5897 | 2018-10-04 |
| 1750881488 | Jennifer Michele Wilson | Licensed Vocational Nurse | 20606 N Interstate 35, West, TX 76691-1812 | 2018-02-19 |
| 1942725700 | Jennifer Lynnette Wilson | Physician Assistant | 282 Equestrian Way, Raeford, NC 28376-7721 | 2017-08-13 |
| 1548782543 | Jennifer Wilson | Nurse Practitioner | 4665 W Atlantic Ave Ste B, Delray Beach, FL 33445-3800 | 2017-07-11 |
| 1770012775 | Jennifer Wilson | Registered Nurse | 3902 Henderson Blvd Ste 202, Tampa, FL 33629-5034 | 2017-06-05 |
| 1174069694 | Jennifer Wilson | Behavior Technician | 2014 Quail Run Dr Ne, Albuquerque, NM 87122-1100 | 2017-01-07 |
| 1033579396 | Jennifer Wilson | Nurse Practitioner | 10001 S Eastern Ave Ste 407, Henderson, NV 89052-3908 | 2016-03-01 |
| Street Address |
11010 PRAIRIE LAKES DR STE 350 |
| City | EDEN PRAIRIE |
| State | MN |
| Zip Code | 55344-3801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972692382 | Sandra Lee Guggisberg | Marriage & Family Therapist | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344 | 2006-10-12 |
| 1710526348 | Denyal Kimber Leclaire | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2019-12-30 |
| 1700448941 | Erica Rose Chavie | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2019-07-08 |
| 1043791676 | Nicole Kay Frass | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2018-08-22 |
| 1871083931 | Susan Clough | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2018-05-15 |
| 1639667256 | Alexa J Thelen | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2018-04-30 |
| 1902393382 | Sarah Jean Sorensen | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2018-04-20 |
| 1083120984 | Breanna Wagner | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2017-12-14 |
| 1356856983 | Lori Ann Gilbertson | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2017-12-05 |
| 1407368327 | Macey Deslauriers | Counselor | 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344-3801 | 2017-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366000572 | Hekima Care Inc. | Case Management | 8725 Columbine Rd Unit 46026, Eden Prairie, MN 55344 | 2019-06-03 |
| 1528537768 | Smile Eden Prairie | Dentist | 6600 City W. Pkwy #315, Eden Prairie, MN 55344 | 2018-11-16 |
| 1215439781 | Angelo Scherer | Counselor | 11010 Prairie Lakes Drive Suite 350, Eden Prairie, MN 55344 | 2018-03-01 |
| 1497272678 | Matthew Lynn | Occupational Therapist | 431 Prairie Center Drive, Eden Prairie, MN 55344 | 2017-08-28 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1609218676 | Nations Care Link | Nurse Practitioner | 11000 Praire Lakes Dr, Suite 600, Eden Praire, MN 55344 | 2013-07-19 |
| 1497020390 | Alixa Rx LLC | Pharmacy | 10132 West 76th St, Eden Prairie, MN 55344 | 2012-03-12 |
| 1831467331 | Eagle Ridge Academy | Local Education Agency (LEA) | 7255 Flying Cloud Drive, Eden Prairie, MN 55344 | 2011-12-12 |
| 1205154739 | Eden Prairie School District 272 | Local Education Agency (LEA) | 8100 School Road, Eden Prairie, MN 55344 | 2010-05-07 |
| 1992030613 | Spinal Health | Chiropractor | 12100 Singletree Ln #129, Eden Prairie, MN 55344 | 2009-10-14 |
| Find all providers in zip 55344 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215366539 | Angela Faye Sovak | Psychologist | 9531 W 78th St Ste 340, Eden Prairie, MN 55344-8001 | 2013-11-06 |
| 1558679282 | Thomas Anthony Worwa | Psychologist | 830 Prairie Center Dr Ste 110, Eden Prairie, MN 55344-7301 | 2010-09-15 |
| 1366761090 | Linnea A Larson | Psychologist | 10200 Wild Duck Pass, Eden Prairie, MN 55347-5029 | 2010-05-20 |
| 1922152966 | Linda Ann Kutz | Psychologist | 250 Prairie Center Dr, Suite 270, Eden Prairie, MN 55344-7909 | 2007-01-23 |
| 1104975705 | Sharon E. Kanters | Psychologist | 8897 Aztec Dr, Eden Prairie, MN 55347-1901 | 2007-01-10 |
| 1891861621 | Kenneth F. Reed | Psychologist | 15832 Venture Ln, Eden Prairie, MN 55344-5732 | 2006-11-24 |
| 1700984226 | Brian Ehrich | Psychologist | 9531 W Est 78th Street, Suite 110, Eden Prairie, MN 55344-3810 | 2006-09-20 |
| 1790890374 | Louis Stephen Bartholome | Psychologist | 11000 Prairie Lakes Dr, Suite 610, Eden Prairie, MN 55344-3885 | 2006-08-21 |
| 1700831575 | Thomas Kuhlman Ph.d., P.a. | Psychologist | 12100 Singletree Ln, Suite 196, Eden Prairie, MN 55344-7919 | 2006-05-23 |
| 1407827173 | Sandra Hammond Taylor | Psychologist | 8897 Aztec Drive, Eden Prairie, MN 55344 | 2006-01-30 |
| Find all providers in EDEN PRAIRIE | ||||
| City | EDEN PRAIRIE |
| Zip Code | 55344 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.