Individual provider Active NPI

Jodi Leirness, PSYD, LP

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1184242885
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LP5948 Issued in MN
Practice address
370 Selby Ave Ste 316
Saint Paul, MN 55102-1965
Phone
(651) 300-1729
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LP5948 MN Primary

Addresses

Primary practice location

370 Selby Ave Ste 316
Saint Paul, MN 55102-1965

Mailing address

5536 Dupont Ave S
Minneapolis, MN 55419-1648
Phone (651) 253-3054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 9, 2026 through Jul 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP5948MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1184242885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 DUPONT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191648",
            "telephone_number": "651-253-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 SELBY AVE STE 316",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021965",
            "telephone_number": "651-300-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIRNESS",
        "first_name": "JODI",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LP5948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.