Individual provider Active NPI

Jessica Metzger, L.M.F.T.

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1477908945
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3262 Issued in MN
Practice address
8421 Wayzata Blvd Ste 250
Golden Valley, MN 55426-1382
Phone
(952) 835-6540
Fax
(952) 835-6650
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3262 MN Primary

Addresses

Primary practice location

8421 Wayzata Blvd Ste 250
Golden Valley, MN 55426-1382

Mailing address

8421 Wayzata Blvd Ste 250
Golden Valley, MN 55426-1382
Phone (952) 835-6540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3262MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Por, LLC PastSince Feb 15, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1477908945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8421 WAYZATA BLVD STE 250",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261382",
            "telephone_number": "952-835-6540",
            "fax_number": "952-835-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8421 WAYZATA BLVD STE 250",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261382",
            "telephone_number": "952-835-6540",
            "fax_number": "952-835-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3262",
            "primary": true
        }
    ],
    "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 3, 2016; 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.