NPIMap

Organization Active NPI

Turning Leaf Therapy

  • Community/Behavioral Health Agency
  • Roseville, MN
National Provider Identifier
1124471107
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2425 Issued in MN
Legal business name
TURNING LEAF THERAPY
Practice address
2589 Hamline Ave N Ste C
Roseville, MN 55113-3185
Phone
(651) 330-6205
Fax
(651) 330-8718
NPI assigned
Jul 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Jennifer M Lake, M.A., LMFTNPI 1801199302
Title
Owner
Phone
(651) 330-6205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2425 MN Primary

Addresses

Primary practice location

2589 Hamline Ave N Ste C
Roseville, MN 55113-3185

Mailing address

2589 Hamline Ave N Ste C
Roseville, MN 55113-3185
Phone (651) 330-6205

Other practice location 1

16182 Highway 7 Lowr Level
Minnetonka, MN 55345-3403
Phone (651) 330-2605

Other practice location 2

2565 Hamline Ave N Ste A
Roseville, MN 55113-3181
Phone (651) 330-6205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200306000676 MN Part B Supplier - Clinic/Group Practice 4688002579 Receives reassigned benefits from 16 practitioners
Practice locations: Minnetonka, MN; Roseville, MN

National Provider Directory

National Provider Directory

Locations

16182 Highway 7
Minnetonka, MN 55345
Phone (651) 330-6205

16182 Highway 7
Lowr
Minnetonka, MN 55345
Phone (651) 330-2605

2233 Hamline Ave N
Ste 411
Roseville, MN 55113
Phone (612) 799-8258

2565 Hamline Ave N
Ste A
Saint Paul, MN 55113
Phone (651) 330-6205

2589 Hamline Ave N
Ste C
Saint Paul, MN 55113
Phone (651) 330-6205

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1124471107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2589 HAMLINE AVE N STE C",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133185",
            "telephone_number": "651-330-6205",
            "fax_number": "651-330-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2589 HAMLINE AVE N STE C",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133185",
            "telephone_number": "651-330-6205",
            "fax_number": "651-330-8718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16182 Highway 7 Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553453403",
            "country_code": "US",
            "telephone_number": "651-330-2605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2565 Hamline Ave N Ste A",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551133181",
            "country_code": "US",
            "telephone_number": "651-330-6205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TURNING LEAF THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-330-6205",
        "authorized_official_credential": "M.A., LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "2425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.