Jade Bender Rafferty, PH.D., LP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

4601 Excelsior Blvd Ste 400
St Louis Park, MN 55416-4977

Phone

(612) 767-9860

Fax

(612) 767-9861

NPI assigned

Oct 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jade Andromeda Bender Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Hope Psychology Practice, LLC

  • Clinical Child & Adolescent Psychologist
  • Minneapolis, MN
  • NPI 1942687397
  Authorized official Same address or phone

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1386997179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-767-9860",
            "fax_number": "612-767-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-767-9860",
            "fax_number": "612-767-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFERTY",
        "first_name": "JADE",
        "middle_name": "BENDER",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "BENDER",
            "middle_name": "ANDROMEDA",
            "prefix": "DR.",
            "credential": "PH.D., LP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Elizabeth Rademacher, M.A.
• Gail A Radosevich, RD, CDE
• Kristen R Radtke
• Sandra Y Rae, OTRL
• Kevin S Raff, MD
• Rai Keystone Imaging Services, LLC (Center for Diagnostic Imaging)
• Daniel Raies, OD
• Elaina Railey, APRN
• Timothy C Rajtora
• Sarah Sween Ramer, PT

• Clinical Child & Adolescent Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Clinical Child & Adolescent Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.