Active NPI
Stacie L Joncas, LP
- Psychologist
- Minneapolis, MN
National Provider Identifier
1255457719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP3053
- Practice address
- 819 2ND Ave S
Minneapolis, MN 55402-2808 - Phone
- (612) 204-8335
- Fax
- (612) 332-5319
- NPI assigned
- Mar 22, 2007
- Last updated
- Mar 26, 2019
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP3053 | MN | Primary |
Addresses
Primary practice location
819 2ND Ave S
Minneapolis, MN 55402-2808
Mailing address
819 2ND Ave S
Minneapolis, MN 55402-2808
Phone (612) 204-8335
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
- Clinical Psychologist
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3053 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amherst H. Wilder Foundation | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Saint Paul, MN
- NPI 1548337355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553558400000",
"number": "1255457719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 2ND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022808",
"telephone_number": "612-204-8335",
"fax_number": "612-332-5319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 2ND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022808",
"telephone_number": "612-204-8335",
"fax_number": "612-332-5319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONCAS",
"first_name": "STACIE",
"middle_name": "L",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2019-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP3053",
"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 Mar 26, 2019; 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.