NPIMap

Organization Active NPI

Summer Counseling and Behavioral Health Summer Counseling

Doing business as Summer Counseling

  • Mental Health Counselor
  • Woodbury, MN
National Provider Identifier
1649815614
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SUMMER COUNSELING AND BEHAVIORAL HEALTH SUMMER COUNSELING
Doing business as
Summer Counseling
Practice address
1687 Woodlane Dr Ste 208
Woodbury, MN 55125-3047
Phone
(651) 327-0849
NPI assigned
Nov 13, 2019
Last updated
Apr 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Jennifer Summer Kokes, MA, LPCCNPI 1689026155
Title
President
Phone
(651) 327-0849

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU
Clinical Neuropsychologist 103G00000X NU
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

1687 Woodlane Dr Ste 208
Woodbury, MN 55125-3047

Mailing address

1687 Woodlane Dr Ste 208
Woodbury, MN 55125-3047
Phone (651) 327-0849

Other names 1

  • Summer Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200701001599 MN Part B Supplier - Clinic/Group Practice 6002239589 Receives reassigned benefits from 2 practitioners
Practice locations: Oakdale, MN

National Provider Directory

National Provider Directory

Locations

7835 3rd St N
Ste 208
Saint Paul, MN 55128
Phone (651) 327-0849

7835 3rd St N
Ste 209
Saint Paul, MN 55128
Phone (651) 327-0849

1687 Woodlane Dr
Ste 208
Woodbury, MN 55125
Phone (507) 951-9980

2042 Wooddale Dr
Ste 125
Woodbury, MN 55125
Phone (651) 327-0849

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1649815614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR STE 208",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253047",
            "telephone_number": "651-327-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR STE 208",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253047",
            "telephone_number": "651-327-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMER COUNSELING AND BEHAVIORAL HEALTH SUMMER COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "KOKES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SUMMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-327-0849",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summer Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summer Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.