Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Pena

Individual provider Professional Counselor · NPI 1073163564

Jacqueline Pena is a Mental Health Counselor in Minneapolis, Minnesota. Qualified in 2019, 7 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
7
Licensed in
MN
In the registry since
2019
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Practice location Address checks out

3801 W 50th St Ste 250B
Minneapolis, MN 55410-2070
Phone: (612) 400-9685
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 4397 (MN)

Record details

NPI number1073163564
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 17, 2019
Last updated in NPPESMay 30, 2024
Certification dateMay 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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