Individual provider Active NPI

Jared Lee, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1306397591
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4626 Issued in MN
Practice address
992 Inwood Ave N
Saint Paul, MN 55128-6625
Phone
(612) 440-7817
NPI assigned
Oct 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4626 MN Primary

Addresses

Primary practice location

992 Inwood Ave N
Saint Paul, MN 55128-6625

Mailing address

1442 Simpson St
Saint Paul, MN 55108-2341
Phone (701) 212-3999

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
I20240812002168 MN Practitioner - Marriage and Family Therapist 3971041781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optimal Brain MN PLLCGroup PAC ID 6709317787, 20 clinicians

Practice addresses (Care Compare)

992 Inwood Ave N
Oakdale, MN 55128-6625
Phone (651) 472-5915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4626MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Brain MN, PLLC CurrentSince Feb 5, 2025 Accepting new patients

Locations

992 Inwood Ave N
Saint Paul, MN 55128
Phone (612) 842-9814

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1306397591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 SIMPSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551082341",
            "telephone_number": "701-212-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 INWOOD AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551286625",
            "telephone_number": "612-440-7817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JARED",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-22",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.