JERILYN MARIE WIEDERHOLT PSYCHOLOGIST
NPI 1962691501
Psychologist - Clinical in Northfield, MN

Q: What is Jerilyn Wiederholt's NPI number?

The NPI number for Jerilyn Wiederholt is 1962691501. It was assigned to this individual provider in the NPPES registry on October 19, 2007.

Q: What is Jerilyn Wiederholt's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since October 19, 2007

209 SPRING ST N, NORTHFIELD, MN 55057(507) 645-4687 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jerilyn Marie Wiederholt Psychologist NPPES

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

JERILYN MARIE WIEDERHOLT PSYCHOLOGIST (NPI 1962691501) is an individual clinical provider in Northfield, Minnesota, licensed in Minnesota (3079) and active in the NPI registry since October 2007.

NPPES Registry Identity

NPI1962691501

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameJERILYN MARIE WIEDERHOLTCredential: PSYCHOLOGIST

Location Address209 SPRING ST NNorthfield, MN 55057-1432

Mailing Address209 Spring St NNorthfield, MN 55057-1432 · (507) 645-4687

Phone(507) 645-4687

Sole ProprietorYes

Enumeration DateOctober 19, 2007

Last NPPES UpdateFebruary 23, 2022

NPPES CertifiedNovember 4, 2021

✔ NPI 1962691501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MN · 3079

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

209 SPRING ST N, Northfield, MN 55057

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Other Identifiers 2

Medicaid066327100MN

Other3079MN · Psychologist License

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerilyn Wiederholt's NPI number?

The NPI number for Jerilyn Wiederholt is 1962691501. It was assigned to this individual provider in the NPPES registry on October 19, 2007.

Where is Jerilyn Wiederholt located?

Jerilyn Wiederholt practices at 209 Spring St N, Northfield, MN 55057. The listed phone number is (507) 645-4687.

What is Jerilyn Wiederholt's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Jerilyn Wiederholt was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.