Individual provider Active NPI

Jonathan David Pieper, MA, LMFT

  • Marriage & Family Therapist
  • Coon Rapids, MN
National Provider Identifier
1619353844
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2963 Issued in MN
Practice address
3915 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520
Phone
(651) 224-4114
Fax
(651) 925-0071
NPI assigned
Aug 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 2963 MN Primary

Addresses

Primary practice location

3915 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520

Mailing address

220 Railroad St SE
Pine City, MN 55063-1540
Phone (320) 629-7600

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
I20240118002194 MN Practitioner - Marriage and Family Therapist 6103278825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Services Agency Inc Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

3907 Coon Rapids Blvd NW
Coon Rapids, MN 55433

3915 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Phone (651) 224-4114

220 Railroad St SE
Pine City, MN 55063

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1619353844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RAILROAD ST SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631540",
            "telephone_number": "320-629-7600",
            "fax_number": "651-925-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332520",
            "telephone_number": "651-224-4114",
            "fax_number": "651-925-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEPER",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-11",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.