NPIMap

Organization Active NPI

Jewish Family & Children's Service of Minneapolis

  • Mental Health Counselor
  • Golden Valley, MN
National Provider Identifier
1477611853
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C01878 Issued in MN
Legal business name
JEWISH FAMILY & CHILDREN'S SERVICE OF MINNEAPOLIS
Practice address
5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone
(952) 546-0616
Fax
(952) 593-1778
NPI assigned
Dec 5, 2006
Last updated
May 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Daniel Belich
Title
Cfo
Phone
(952) 546-0616

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X C01878 MN Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 3785 MN

Addresses

Primary practice location

5905 Golden Valley Rd
Golden Valley, MN 55422-4463

Mailing address

5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone (952) 546-0616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000660 MN Part B Supplier - Clinic/Group Practice 3870532500 Receives reassigned benefits from 9 practitioners
Practice locations: Golden Valley, MN

National Provider Directory

National Provider Directory
Tax ID family
Jewish Family and Children's Service4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5905 Golden Valley Rd
Minneapolis, MN 55422
Phone (952) 546-0616

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1477611853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224463",
            "telephone_number": "952-546-0616",
            "fax_number": "952-593-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224463",
            "telephone_number": "952-546-0616",
            "fax_number": "952-593-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY & CHILDREN'S SERVICE OF MINNEAPOLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BELICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-546-0616"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "C01878",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.