Individual provider Active NPI

Jessica Christine Smith, LMFT

  • Marriage & Family Therapist
  • Eden Prairie, MN
National Provider Identifier
1043734122
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3506 Issued in MN
Practice address
6542 Regency LN Ste 213
Eden Prairie, MN 55344-7848
Phone
(952) 214-1638
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3506 MN Primary

Addresses

Primary practice location

6542 Regency LN Ste 213
Eden Prairie, MN 55344-7848

Mailing address

13240 Flagstaff Ave
Apple Valley, MN 55124-7938
Phone (651) 262-6152

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
I20241219003788 MN Practitioner - Marriage and Family Therapist 0345777918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

6542 Regency LN
Suite 213
Eden Prairie, MN 55344-7848
Phone (763) 218-8602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Base Counseling Center LLC Marriage & Family Therapist CurrentSince Dec 1, 2024 Accepting new patients
Vibe Integrated Health Marriage & Family Therapist CurrentSince Nov 11, 2025 Accepting new patients
Encompass Hope, LLC Marriage & Family Therapist PastSince Jun 1, 2020 Accepting new patients

Locations

6542 Regency Ln
Ste 213
Eden Prairie, MN 55344
Phone (763) 218-8602

213 1st St
Farmington, MN 55024
Phone (507) 301-3412

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

Organizations & group practices 3

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1043734122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13240 FLAGSTAFF AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247938",
            "telephone_number": "651-262-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6542 REGENCY LN STE 213",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447848",
            "telephone_number": "952-214-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.