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

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



Healthcare Provider's Profile

Full NameMrs Jennifer Ann Ullom
GenderFemale
SpecialityPsychologist - Counseling
Location700 Twelve Oaks Center Dr, Wayzata, Minnesota
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1366643868NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist LPP161LP5067 (Minnesota)Secondary
103TC1900XPsychologist - 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 AddressPractice 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

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› Verified 3 days ago


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    

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