Individual provider Active NPI

Jennifer Sue Johnson, MA, LPCC

  • Professional Counselor
  • Eagan, MN
National Provider Identifier
1356993125
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC3552 Issued in MN
Practice address
3410 Federal Drive
Suite 101
Eagan, MN 55122
Phone
(651) 560-0050
Fax
(651) 925-0257
NPI assigned
Jul 11, 2019
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Professional Counselor 101YP2500X LPCC3552 MN Primary

Addresses

Primary practice location

3410 Federal Drive
Suite 101
Eagan, MN 55122

Mailing address

3410 Federal Drive
Suite 101
Eagan, MN 55122
Phone (651) 560-0050

Other names 1

  • Miss Jennifer Sue Becvar Former name

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
I20240307003051 MN Practitioner - Mental Health Counselor 6002252418 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
Telehealth
Offers telehealth services
Group practices
Threads of Hope Counseling LLCGroup PAC ID 5890139620, 9 clinicians

Practice addresses (Care Compare)

3460 Washington Dr
Suite 109
Eagan, MN 55122-4301
Phone (651) 560-0050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPCC3552MNMDProfessional Counselor
3552MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Threads of Hope Counseling, LLC Professional CurrentSince Feb 23, 2024 Accepting new patients

Locations

3410 Federal Dr
Ste 101
Eagan, MN 55122
Phone (651) 788-9008

3460 Washington Dr
Ste 109
Saint Paul, MN 55122
Phone (612) 440-2678

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.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1356993125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 FEDERAL DRIVE",
            "address_2": "SUITE 101",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-560-0050",
            "fax_number": "651-925-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FEDERAL DRIVE",
            "address_2": "SUITE 101",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-560-0050",
            "fax_number": "651-925-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "LPCC3552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BECVAR",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "MA, LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.