Active NPI
Jessica Chamberlin
- Marriage & Family Therapist
- Lakeville, MN
National Provider Identifier
1205514783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4254
- Practice address
- 10535 165TH St W
Lakeville, MN 55044-5729 - Phone
- (952) 435-0022
- NPI assigned
- Jul 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4254 | MN | Primary |
Addresses
Primary practice location
10535 165TH St W
Lakeville, MN 55044-5729
Mailing address
10535 165TH St W
Lakeville, MN 55044-5729
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10535 165TH St W
Lakeville, MN 55044-5729
Phone (952) 435-0022
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairweather Investments, LLC | Current | Accepting new patients | |
| Lakeville Behavioral Health, LLC | Past | Accepting new patients |
Locations
10535 165th St W
Lakeville, MN 55044
Phone (952) 435-0022
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Lakeville, MN
- NPI 1982238770
-
- Cognitive & Behavioral Psychologist
- Lakeville, MN
- NPI 1750412680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1205514783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10535 165TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550445729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 165TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550445729",
"telephone_number": "952-435-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLIN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-06",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "4254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.