Jacquelyn K. Wiersma, Ph. D., LP, PLLC
NPI 1770696726ActiveOrganization· Psychologist, Clinical· Minnetonka, MN
Psychologist, Clinical in Minnetonka, Minnesota, registered in NPPES in August 2006. The authorized official on file is Jacquelyn K. Wiersma, PH. D., Chief Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770696726 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 16, 2006 |
| Last updated in NPPES | Apr 5, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP1583 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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