Individual provider Active NPI

Jenny Lynn Jorgensen-Kuphal, MA

  • Mental Health Counselor
  • Owatonna, MN
National Provider Identifier
1194440024
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1414 S Oak Ave Ste 6
Owatonna, MN 55060-3957
Phone
(507) 676-6834
NPI assigned
Oct 4, 2022
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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 NU Primary

Addresses

Primary practice location

1414 S Oak Ave Ste 6
Owatonna, MN 55060-3957

Mailing address

1414 S Oak Ave Ste 6
Owatonna, MN 55060-3957
Phone (507) 676-6834

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
I20260325000916 MN Practitioner - Mental Health Counselor 7416431622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1775 Crestview LN
Owatonna, MN 55060-2043

245 18TH St SE
Suite 102
Owatonna, MN 55060-4003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Experiencing Moore, PC CurrentSince Oct 9, 2022 Accepting new patients

Locations

1414 S Oak Ave
Ste 6
Owatonna, MN 55060
Phone (507) 363-9063

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": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1194440024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S OAK AVE STE 6",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603957",
            "telephone_number": "507-676-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S OAK AVE STE 6",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603957",
            "telephone_number": "507-676-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN-KUPHAL",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.