Active NPI
Jordan Rose Leonhardt, MS, LPCC
- Mental Health Counselor
- Austin, MN
National Provider Identifier
1093225757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC01405
- Practice address
- 1111 28TH St NE
Austin, MN 55912-6410 - Phone
- (507) 434-4366
- Fax
- (507) 433-7868
- NPI assigned
- Oct 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC01405 | MN | Primary |
Addresses
Primary practice location
1111 28TH St NE
Austin, MN 55912-6410
Mailing address
1111 28TH St NE
Austin, MN 55912-6410
Phone (507) 434-4413
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC01405 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerard Treatment Programs, LLC | Past | Accepting new patients |
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.
-
- Child & Adolescent Psychiatry Physician
- Austin, MN
- NPI 1750631115
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1093225757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 28TH ST NE",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559126410",
"telephone_number": "507-434-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 28TH ST NE",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559126410",
"telephone_number": "507-434-4366",
"fax_number": "507-433-7868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONHARDT",
"first_name": "JORDAN",
"middle_name": "ROSE",
"credential": "MS, LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-09",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC01405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.