Individual provider Active NPI

Jessica Sawyer, M.A., L.M.F.T

  • Marriage & Family Therapist
  • New Brighton, MN
National Provider Identifier
1558766998
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1996 Issued in MN
Practice address
900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414
Phone
(612) 706-9630
Fax
(612) 706-9617
NPI assigned
Oct 28, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 1996 MN Primary

Addresses

Primary practice location

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Mailing address

79 13TH Ave NE
103B
Minneapolis, MN 55413-1070
Phone (612) 234-7266

Other practice location 1

79 13th Ave NE
103B
Minneapolis, MN 55413-1070
Phone (612) 234-7266

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
1996MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care Services, PA PastSince Jan 3, 1999 Accepting new patients
Health and Wellness Collaborative Marriage & Family Therapist PastSince Sep 21, 2021 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, 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": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1558766998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 13TH AVE NE",
            "address_2": "103B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131070",
            "telephone_number": "612-234-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630",
            "fax_number": "612-706-9617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 13th Ave NE",
            "address_2": "103B",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554131070",
            "country_code": "US",
            "telephone_number": "612-234-7266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "JESSICA",
        "credential": "M.A., L.M.F.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.