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NPI Code Detail

MEDICARE: JOLENE A PUNDSACK MS LPCC PLLC

MEDICARE: JOLENE A PUNDSACK MS LPCC PLLC
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 Counselor

General Provider Information

NPI Number : 1417575572
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOLENE A PUNDSACK MS LPCC PLLC
Provider Business Mailing Address
First Line : 324 BROADWAY ST STE 206
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-1482
Country : US
Telephone Number : 320-333-7901
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 : 320-762-1762
Authorized Official
Title or Position : OWNER/LPCC
Name : JOLENE ANNA PUNDSACK
Credential : MS LPCC
Telephone Number : 320-333-7901
Provider Enumeration Date : 07/06/2020
Last Update Date : 02/09/2026

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