Individual provider Active NPI

Charles Wilson Jones, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1184098949
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2401 Issued in MN
Practice address
525 Portland Ave
MC 963
Minneapolis, MN 55415-1533
Phone
(612) 348-2233
Fax
(612) 677-6357
NPI assigned
Nov 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2401 MN Primary

Addresses

Primary practice location

525 Portland Ave
MC 963
Minneapolis, MN 55415-1533

Mailing address

525 Portland Ave
MC 963
Minneapolis, MN 55415-1533
Phone (612) 348-2233

Other practice location 1

207 Jefferson Blvd
Big Lake, MN 55309-4667
Phone (763) 367-6080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006000712 MN Practitioner - Marriage and Family Therapist 7113423419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

207 Jefferson Blvd
Big Lake, MN 55309-4667
Phone (763) 367-6080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2401MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Marriage & Family Therapist CurrentSince Aug 25, 2025 Accepting new patients
Family Support Services Inc. PastSince Aug 25, 2025 Accepting new patients

Locations

207 Jefferson Blvd
Big Lake, MN 55309
Phone (763) 367-6080

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1184098949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE",
            "address_2": "MC 963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-2233",
            "fax_number": "612-677-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE",
            "address_2": "MC 963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-2233",
            "fax_number": "612-677-6357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "MN",
            "postal_code": "553094667",
            "country_code": "US",
            "telephone_number": "763-367-6080",
            "fax_number": "763-263-7897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "CHARLES",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.