Individual provider Active NPI

Jenna Hassanein Raad

  • Behavior Analyst
  • Bloomington, MN
National Provider Identifier
1053995597
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0975 Issued in MN
Practice address
7901 Xerxes Ave S Ste 116
Bloomington, MN 55431-1200
Phone
(612) 201-2468
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA0975 MN Primary

Addresses

Primary practice location

7901 Xerxes Ave S Ste 116
Bloomington, MN 55431-1200

Mailing address

6881 Channel Rd NE
Fridley, MN 55432-4619
Phone (612) 434-9679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1053995597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6881 CHANNEL RD NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324619",
            "telephone_number": "612-434-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 XERXES AVE S STE 116",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311200",
            "telephone_number": "612-201-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAD",
        "first_name": "JENNA",
        "middle_name": "HASSANEIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "LBA0975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.