Individual provider Active NPI

Jonathan Michael Guzman, MA, LPCC

  • Mental Health Counselor
  • Bloomington, MN
National Provider Identifier
1013558055
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3453 Issued in MN
Practice address
1550 American Blvd E Ste 550
Bloomington, MN 55425-3100
Phone
(612) 268-5858
Fax
(612) 268-5868
NPI assigned
Oct 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3453 MN Primary
Professional Counselor 101YP2500X 3453 MN

Addresses

Primary practice location

1550 American Blvd E Ste 550
Bloomington, MN 55425-3100

Mailing address

7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone (612) 268-5858

Other practice location 1

7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone (612) 268-5858

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
I20240508002141 MN Practitioner - Mental Health Counselor 4486095494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Affinity Psychological Services PCGroup PAC ID 0749528552, 66 clinicians

Practice addresses (Care Compare)

1550 American Blvd E
Suite 550
Bloomington, MN 55425-1139
Phone (612) 268-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3453MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Mar 26, 2024 Accepting new patients

Locations

1550 American Blvd E
Ste 550
Bloomington, MN 55425
Phone (612) 504-2031

7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

Organizations & group practices 1

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": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1013558055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-268-5858",
            "fax_number": "612-268-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 AMERICAN BLVD E STE 550",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554253100",
            "telephone_number": "612-268-5858",
            "fax_number": "612-268-5868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7401 Metro Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554393062",
            "country_code": "US",
            "telephone_number": "612-268-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-01",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3453",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.