Jessica Leigh Koehn, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4138 Issued in MN

Practice address

1455 Saint Francis Ave
Shakopee, MN 55379-3374

Phone

(952) 428-4050

NPI assigned

Nov 19, 2019

Last updated

Oct 24, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1457997025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "866-603-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793374",
            "telephone_number": "952-428-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 78th Ave N Ste 101",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554452719",
            "country_code": "US",
            "telephone_number": "763-432-6875",
            "fax_number": "763-432-6894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21000 Rogers Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "MN",
            "postal_code": "553744926",
            "country_code": "US",
            "telephone_number": "763-291-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4138",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.allina.html",
            "affiliation": "Y",
            "endpointDescription": "Allina",
            "affiliationName": "Allina Health System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1455 Saint Francis Ave",
            "city": "Shakopee",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553793374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.