Jacqueline Kelly-faddler, MS, LPCC in Princeton, MN

Jacqueline Kelly-faddler, MS, LPCC is a medicare enrolled "Counselor - Professional" provider in Princeton, Minnesota. Her current practice location is 501 4th St S Ste 201, Princeton, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 498-1822.

Jacqueline Kelly-faddler is licensed to practice in Minnesota (license number 842) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1881020527.

Contact Information

	Jacqueline Kelly-faddler, MS, LPCC
	501 4th St S Ste 201, Princeton, MN 55371-4754
	(763) 498-1822
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jacqueline Kelly-faddler
Gender	Female
Speciality	Counselor - Professional
Location	501 4th St S Ste 201, Princeton, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1881020527
Provider Enumeration Date: 09/25/2013
Last Update Date: 05/02/2022

Medicare PECOS Information:

PECOS PAC ID: 3476097098
Enrollment ID: I20240706000216

Medical Identifiers

Medical identifiers for Jacqueline Kelly-faddler such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881020527	NPI	-	NPPES
1881020527	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	842 (Minnesota)	Primary

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. Jacqueline Kelly-faddler allows following entities to bill medicare on her behalf.

Entity Name	Trilogy Counseling Services Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497246433 PECOS PAC ID: 2567906183 Enrollment ID: O20240706000195

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. Jacqueline Kelly-faddler 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
Jacqueline Kelly-faddler, MS, LPCC 501 4th St S Ste 201, Princeton, MN 55371-4754 Ph: (763) 482-1185	Jacqueline Kelly-faddler, MS, LPCC 501 4th St S Ste 201, Princeton, MN 55371-4754 Ph: (763) 498-1822

Reviews and Comments

Counselor in Princeton, MN

Ashley Carlson, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 6th Ave S, Princeton, MN 55371 Phone: 763-308-0006 Fax: 763-631-0339
Mrs. Teri Struthers, M.A.,NCC, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2061 100th Ave, Princeton, MN 55371 Phone: 763-360-2585
Ms. Alexandra Blonigen, BA, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 6th Ave S, Princeton, MN 55371 Phone: 763-308-0006 Fax: 763-631-0339
Kya Rud, Counselor Medicare: Not Enrolled in Medicare Practice Location: 604 1st St, Princeton, MN 55371 Phone: 763-412-1700 Fax: 763-324-8181
Donna Wahlstrom, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 6th Ave S, Princeton, MN 55371 Phone: 763-308-0006
Mr. Andrew Sudbeck, BS, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 101 18th Avenue North, Princeton, MN 55371 Phone: 763-389-5080 Fax: 763-631-9117
Chelsea Jean Petras, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1506 1st St, Princeton, MN 55371 Phone: 763-389-5080 Fax: 763-389-5453

Jacqueline Kelly-faddler, MS, LPCC - Medicare Counselor in Princeton, MN