Kimberly Jara, M.A., LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2198 Issued in MN

Practice address

701 Dellwood St S
Cambridge, MN 55008-1920

Phone

(763) 689-8700

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1568013118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELLWOOD ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081920",
            "telephone_number": "763-689-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5155 E River Rd",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554211025",
            "country_code": "US",
            "telephone_number": "763-780-3307 x118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARA",
        "first_name": "KIMBERLY",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "2198",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.