JOLENE ANNA PUNDSACK MS, LPCC,
NPI 1215296892
Counselor - Mental Health in Alexandria, MN

Q: What is Jolene Pundsack's NPI number?

The NPI number for Jolene Pundsack is 1215296892. It was assigned to this individual provider in the NPPES registry on May 16, 2012.

Q: What is Jolene Pundsack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Jolene Pundsack enrolled in Medicare?

No. Jolene Pundsack has opted out of Medicare through February 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jolene Pundsack was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 16, 2012Opted out of Medicare · through Feb 9, 2028

324 BROADWAY ST STE 206, ALEXANDRIA, MN 56308(320) 762-1762(320) 762-0796 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2020, Apr 8, 2019 (2 updates tracked since 2019).

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About Jolene Anna Pundsack Ms, Lpcc, NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOLENE ANNA PUNDSACK MS, LPCC, (NPI 1215296892) is an individual mental health provider in Alexandria, Minnesota, licensed in Minnesota (CC00476) and active in the NPI registry since May 2012. She has opted out of Medicare through February 9, 2028.

NPPES Registry Identity

NPI1215296892

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJOLENE ANNA PUNDSACKCredential: MS, LPCC,

Location Address324 BROADWAY ST STE 206Alexandria, MN 56308-1482

Mailing Address324 Broadway St Ste 206Alexandria, MN 56308-1482 · (320) 762-1762 · Fax (320) 762-0796

Phone(320) 762-1762

Fax(320) 762-0796

Sole ProprietorYes

Enumeration DateMay 16, 2012

Last NPPES UpdateFebruary 9, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2026

✔ NPI 1215296892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MN · CC00476

324 BROADWAY ST STE 206, Alexandria, MN 56308

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Jolene Anna Pundsack Ms, Lpcc, has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 9, 2026 through February 9, 2028.

Opt-Out Effective DateFebruary 9, 2026

Opt-Out In Effect ThroughFebruary 9, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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