Individual provider Active NPI

Lenny Lawrence Jennings, PH.D, L.P.

  • Counseling Psychologist
  • Edina, MN
National Provider Identifier
1508075573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
MNLP3388 Issued in MN
Practice address
3919 W 44TH St Ste 200
Edina, MN 55424-1032
Phone
(952) 922-1977
Fax
(952) 922-1980
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X MNLP3388 MN Primary

Addresses

Primary practice location

3919 W 44TH St Ste 200
Edina, MN 55424-1032

Mailing address

3919 W 44TH St Ste 200
Edina, MN 55424-1032
Phone (952) 922-1977

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MNLP3388MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Denise H. Bisanz, P.a. Past Accepting new patients
Institute for Therapy & Behavior Change, LTD. Past Accepting new patients

Organizations & group practices 2

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508075573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 W 44TH ST STE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241032",
            "telephone_number": "952-922-1977",
            "fax_number": "952-922-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 W 44TH ST STE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241032",
            "telephone_number": "952-922-1977",
            "fax_number": "952-922-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "LENNY",
        "middle_name": "LAWRENCE",
        "credential": "PH.D, L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "MNLP3388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.