Jennifer L Tichenor, MA LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2627 Issued in MN

Practice address

2103 County Road D E
Suite a
Maplewood, MN 55109-5357

Phone

(651) 338-9816

Fax

(651) 305-0277

NPI assigned

Dec 21, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 14, 2024 through Jan 14, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Maplewood Wellness Center of Minnesota

  • Marriage & Family Therapist
  • Maplewood, MN
  • NPI 1083167340
  NPD (past)

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471132800000",
    "number": "1013253889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 COUNTY ROAD D E",
            "address_2": "SUITE A",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095357",
            "telephone_number": "651-338-9816",
            "fax_number": "651-305-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 COUNTY ROAD D E",
            "address_2": "SUITE A",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095357",
            "telephone_number": "651-338-9816",
            "fax_number": "651-305-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICHENOR",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-21",
        "last_updated": "2016-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Y Thomas, MD
• Kaitlin Ileen Thompson, RD
• Sarah Rachel Thompson, RN
• Brandon Thrash
• Thrive Counseling and Consultation PLLC
• Tillges Certified Orthotic Prosthetic, Inc.
• Kelli Lynn Tischer, MSW, LICSW
• Ashley Tix, RD, LD
• Nada Tohu
• Brian Tolly, M.D.

• Marriage & Family Therapist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.