Individual provider Active NPI

Jennifer Gozy, PSYD, LP

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1003141979
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP5159 Issued in MN
Practice address
7601 Wayzata Blvd
Minneapolis, MN 55426-1626
Phone
(612) 223-8898
Fax
(612) 223-8899
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP5159 MN Primary

Addresses

Primary practice location

7601 Wayzata Blvd
Minneapolis, MN 55426-1626

Mailing address

7601 Wayzata Blvd
Minneapolis, MN 55426-1623
Phone (612) 447-0592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718000178 MN Practitioner - Clinical Psychologist 8921489337 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP5159MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Apr 15, 2025 Accepting new patients
Care Clinics, LLC CurrentSince Jun 13, 2022 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 15, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical Current Accepting new patients
Optum Behavioral Care of Colorado PC Past Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

8980 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 501-1467

1155 Northland Dr
Saint Paul, MN 55120
Phone (612) 223-8899

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1003141979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261623",
            "telephone_number": "612-447-0592",
            "fax_number": "612-223-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261626",
            "telephone_number": "612-223-8898",
            "fax_number": "612-223-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.