Individual provider Active NPI

Jamie Larson Jones, R.D., M.S., L.P.C.C.

  • Counselor
  • Minneapolis, MN
National Provider Identifier
1275605388
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1363 Issued in MN
Practice address
4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone
(612) 615-2700
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1363 MN Primary
Mental Health Counselor 101YM0800X 1363 MN

Addresses

Primary practice location

4208 Park Glen Rd
Minneapolis, MN 55416-4758

Mailing address

4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone (612) 825-4792

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
I20241121001106 MN Practitioner - Mental Health Counselor 4880129329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGC LLCGroup PAC ID 4284169723, 9 clinicians

Practice addresses (Care Compare)

4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone (612) 825-4792

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
972MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients
Cabot Psychological Services, PLLC Past Accepting new patients

Locations

333 Washington Ave N
Minneapolis, MN 55401
Phone (612) 349-2797

4208 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 825-4792

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1275605388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-825-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-615-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON JONES",
        "first_name": "JAMIE",
        "credential": "R.D., M.S., L.P.C.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "1363",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1363",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.