Individual provider Active NPI

Jennifer Danlee Moore, LPC

  • Professional Counselor
  • Minneapolis, MN
National Provider Identifier
1508385857
Registry record updated Nov 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5295 Issued in MN
Practice address
3040 17TH Ave S
Minneapolis, MN 55407-1819
Phone
(317) 987-6394
NPI assigned
Sep 18, 2017
Last updated
Nov 30, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5295 MN Primary

Addresses

Primary practice location

3040 17TH Ave S
Minneapolis, MN 55407-1819

Mailing address

3040 17TH Ave S
Minneapolis, MN 55407-1819
Phone (317) 987-6394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260204002162 MN Practitioner - Mental Health Counselor 5193204782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1409 Willow St
Suite 400
Minneapolis, MN 55403-3251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5295MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Transcend Psychotherapy, PLLC Professional CurrentSince Dec 27, 2025 Accepting new patients
Peoplefirst Clinic PLLC CurrentSince Feb 2, 2025 Accepting new patients
Jen Moore Counseling Services, LLC Past Accepting new patients

Locations

1409 Willow St
Ste 400
Minneapolis, MN 55403
Phone (612) 445-0225

1422 W Lake St
Ste 314
Minneapolis, MN 55408
Phone 6124450225 ext. 11

652 Bielenberg Dr
Ste 202
Woodbury, MN 55125
Phone (651) 317-3902

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764460800000",
    "number": "1508385857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071819",
            "telephone_number": "317-987-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071819",
            "telephone_number": "317-987-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "DANLEE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2017-09-18",
        "last_updated": "2025-11-30",
        "certification_date": "2025-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "5295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.