Individual provider Active NPI

Jenna Rae Kohles Hutchinson, PH.D.

  • School Psychologist
  • Minneapolis, MN
National Provider Identifier
1124175187
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
252403 Issued in MN
Practice address
807 Broadway St NE
Minneapolis, MN 55413-2332
Phone
(612) 668-8693
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 252403 MN Primary
Psychologist 103T00000X LP1514 MN

Addresses

Primary practice location

807 Broadway St NE
Minneapolis, MN 55413-2332

Mailing address

5319 Knox Ave S
Minneapolis, MN 55419-1043
Phone (612) 926-7778

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP1514MNMDPsychologist
252403MNMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124175187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 KNOX AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191043",
            "telephone_number": "612-926-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132332",
            "telephone_number": "612-668-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "JENNA",
        "middle_name": "RAE KOHLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "252403",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.