Individual provider Active NPI

Jasmine Vasquez, LMFT

  • Marriage & Family Therapist
  • Elk River, MN
National Provider Identifier
1528666435
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4219 Issued in MN
Practice address
12580 192ND CT NW Ste F
Elk River, MN 55330-5085
Phone
(763) 200-6078
NPI assigned
Oct 13, 2020
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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 4219 MN Primary

Addresses

Primary practice location

12580 192ND CT NW Ste F
Elk River, MN 55330-5085

Mailing address

12580 192ND CT NW Ste F
Elk River, MN 55330-5085
Phone (763) 200-6078

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
I20250926003394 MN Practitioner - Marriage and Family Therapist 9234634411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12580 192ND CT NW
Suite F
Elk River, MN 55330-5085

7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geryol Consulting LLC Marriage & Family Therapist CurrentSince Jul 18, 2025 Accepting new patients

Locations

12580 192nd Ct NW
Ste F
Elk River, MN 55330
Phone (763) 200-6046

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, 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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1528666435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12580 192ND CT NW STE F",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553305085",
            "telephone_number": "763-200-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12580 192ND CT NW STE F",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553305085",
            "telephone_number": "763-200-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JASMINE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.