NPIMap

Organization Active NPI

Numa Psychotherapy PLLC

  • Professional Counselor
  • Minneapolis, MN
National Provider Identifier
1124500855
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
01625 Issued in MN
Legal business name
NUMA PSYCHOTHERAPY PLLC
Practice address
708 N 1St St Ste 242
Minneapolis, MN 55401-1145
Phone
(507) 208-3504
NPI assigned
Aug 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Krista Marie Jorgenson, MA, LPCCNPI 1114445210
Title
Psychotherapist
Phone
(507) 208-3504

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 01625 MN Primary

Addresses

Primary practice location

708 N 1St St Ste 242
Minneapolis, MN 55401-1145

Mailing address

708 N 1St St Ste 242
Minneapolis, MN 55401-1145
Phone (507) 208-3504

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241119001185 MN Part B Supplier - Clinic/Group Practice 2860927514 Receives reassigned benefits from 5 practitioners
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

708 N 1st St
Ste 234
Minneapolis, MN 55401
Phone (612) 251-9322

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1124500855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 N 1ST ST STE 242",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011145",
            "telephone_number": "507-208-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 N 1ST ST STE 242",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011145",
            "telephone_number": "507-208-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUMA PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "JORGENSON",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "507-208-3504",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01625",
            "primary": true
        }
    ],
    "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 Nov 12, 2024; 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.