Individual provider Active NPI

Jill Gurwitz Kozberg, M. A.

  • Counseling Psychologist
  • Minnetonka, MN
National Provider Identifier
1295803765
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP3372 Issued in MN
Practice address
13100 Wayzata Blvd
Suite 400
Minnetonka, MN 55305-1802
Phone
(952) 546-0616
Fax
(952) 593-1778
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3372 MN
Counseling Psychologist 103TC1900X LP3372 MN Primary

Addresses

Primary practice location

13100 Wayzata Blvd
Suite 400
Minnetonka, MN 55305-1802

Mailing address

9901 Saint Johns Rd
Minnetonka, MN 55305-4640
Phone (952) 936-0926

Other identifiers 1

IdentifierTypeStateIssuer
8H790KO 4H557GI LPOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3372MNMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295803765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 SAINT JOHNS RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553054640",
            "telephone_number": "952-936-0926",
            "fax_number": "952-936-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 WAYZATA BLVD",
            "address_2": "SUITE 400",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051802",
            "telephone_number": "952-546-0616",
            "fax_number": "952-593-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZBERG",
        "first_name": "JILL",
        "middle_name": "GURWITZ",
        "credential": "M. A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3372",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP3372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8H790KO  4H557GI LP",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.