Mrs Jennifer Ann Ullom, MA, LP in Wayzata, MN - Medicare Psychologist Provider

Mrs Jennifer Ann Ullom, MA, LP is a medicare enrolled "Psychologist - Counseling" provider in Wayzata, Minnesota. Her current practice location is 700 Twelve Oaks Center Dr, Ste 204, Wayzata, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 306-8499.

Mrs Jennifer Ann Ullom is licensed to practice in Minnesota (license number LP5067) 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 1366643868.

Contact Information

	Mrs Jennifer Ann Ullom, MA, LP
	700 Twelve Oaks Center Dr, Ste 204, Wayzata, MN 55391-4415
	(612) 306-8499
	(651) 374-9641

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Jennifer Ann Ullom
Gender	Female
Speciality	Psychologist - Counseling
Location	700 Twelve Oaks Center Dr, Wayzata, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366643868
Provider Enumeration Date: 05/30/2007
Last Update Date: 08/18/2020

Medicare PECOS Information:

PECOS PAC ID: 8729492061
Enrollment ID: I20210128001640

Medical Identifiers

Medical identifiers for Mrs Jennifer Ann Ullom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366643868	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	LPP161LP5067 (Minnesota)	Secondary
103TC1900X	Psychologist - Counseling	LP5067 (Minnesota)	Primary

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. Mrs Jennifer Ann Ullom 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
Mrs Jennifer Ann Ullom, MA, LP 7513 Inland Ln N, Maple Grove, MN 55311-3954 Ph: (612) 998-5162	Mrs Jennifer Ann Ullom, MA, LP 700 Twelve Oaks Center Dr, Ste 204, Wayzata, MN 55391-4415 Ph: (612) 306-8499

Reviews and Comments

Psychologist in Wayzata, MN

Mr. Brian Vernon Nelson, LP, LSP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3305 Casco Cir, Wayzata, MN 55391 Phone: 952-471-7211 Fax: 952-471-7211
Dr. Sherry Machen, PHD LP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 205 Barry Ave S, #201, Wayzata, MN 55391 Phone: 952-473-0668
Joanne May, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 18322 Minnetonka Blvd Ste C, Wayzata, MN 55391 Phone: 952-475-2818 Fax: 952-475-3356
Natasha Manish Parekh, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 700 Twelve Oaks Center Dr, Wayzata, MN 55391 Phone: 952-209-1510
Dr. Elizabeth Kennedy Ward, Psychologist Medicare: Medicare Enrolled Practice Location: 18300 Minnetonka Blvd Ste 204, Wayzata, MN 55391 Phone: 952-222-4284
Carole Louise Selin, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 431 Peavey Ln, Wayzata, MN 55391 Phone: 952-473-4400
Dr. Carol Lee Kuster, PH.D., L.P. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19650 Chimo West St, Wayzata, MN 55391 Phone: 952-475-9070

Mrs Jennifer Ann Ullom, MA, LP - Medicare Psychologist in Wayzata, MN