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NPI Code Detail

MEDICARE: JOLENE ANNA PUNDSACK MS, LPCC,

MEDICARE: JOLENE ANNA PUNDSACK MS, LPCC,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCC00476MN

General Provider Information

NPI Number : 1215296892
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLENE ANNA PUNDSACK MS, LPCC,
Provider Business Mailing Address
First Line : 324 BROADWAY ST STE 206
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-1482
Country : US
Telephone Number : 320-762-1762
Fax Number : 320-762-0796
Provider Business Practice Location Address
First Line : 324 BROADWAY ST STE 206
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-1482
Country : US
Telephone Number : 320-762-1762
Fax Number : 320-762-0796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2012
Last Update Date : 02/09/2026

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