Jennifer Blanca Kelley, MS., IN MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

1144 29TH Ave N
Saint Cloud, MN 56303-5632

Phone

(320) 260-6772

Fax

(855) 291-6387

NPI assigned

Feb 23, 2023

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Unity Family Couples & Individual Therapy Services LLC

  • Professional Counselor
  • Saint Cloud, MN
  • NPI 1073212106
  NPD Authorized official

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1477252955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633",
            "city": "COLD SPRING",
            "state": "MN",
            "postal_code": "563200633",
            "telephone_number": "320-260-6772",
            "fax_number": "855-291-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 29TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035632",
            "telephone_number": "320-260-6772",
            "fax_number": "855-291-6387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14775 Patch Lake Circle",
            "address_2": "Cold Spring MN, 56320",
            "address_purpose": "LOCATION",
            "city": "Cold Spring",
            "state": "MN",
            "postal_code": "563205632",
            "country_code": "US",
            "telephone_number": "320-260-6772",
            "fax_number": "855-291-6387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JENNIFER",
        "middle_name": "BLANCA",
        "name_prefix": "Ms.",
        "credential": "MS., IN MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUT OF NETWORK POLICY AND MOST CREDIT CARDS ARE ACCEPTED",
            "identifier": "7569867",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey L Kehl, RRT
• Keith Larson Neurology PLLC
• Julie Ann Keller Dornbusch, APRN
• Elissa Keller, RBT
• Crystal Amanda Kelley
• Leslie Marie Kellor-Wentland
• Michael Cashman Kelly, MS - LP
• Brian Kelzenberg
• Benjamin Kemper, ATC
• Elisha Kemper, BSN

• Marriage & Family Therapist in Saint Cloud, MN
• Providers in Saint Cloud, 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 Feb 23, 2023; 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.