Jennifer Joy Kortgard, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21266 Issued in MN

Practice address

1919 University Ave W Ste 200
Saint Paul, MN 55104-3435

Phone

(651) 266-7999

Fax

(651) 266-7850

NPI assigned

Sep 8, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer Hanel Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Twin Cities Teen Counseling LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1255805800
  NPD Authorized official

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1376911362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 N 4TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112159",
            "telephone_number": "612-201-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043435",
            "telephone_number": "651-266-7999",
            "fax_number": "651-266-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2375 University Ave W Ste 160",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141632",
            "country_code": "US",
            "telephone_number": "612-548-4948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORTGARD",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "21266",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255805800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HANEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric J Korbach, MD
• Phillip Korkowski, RN
• Abrina K Korman, NP
• Dennis H Korn
• Rory S Kortan, CRNA
• Lee Korthof, PT
• Taylor Korynta, LICSW
• Therese Anne Kosch, RPT
• Kevin Kosel, DPT
• Gwendolyn Martinique Kosevich, MSN

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.