Individual provider Active NPI

Jennifer Marie Metzger, LADC

  • Mental Health Counselor
  • Lakeville, MN
National Provider Identifier
1669061230
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
17685 Juniper Path Ste 301
Lakeville, MN 55044-9821
Phone
(651) 628-9566
NPI assigned
Jan 18, 2021
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

17685 Juniper Path Ste 301
Lakeville, MN 55044-9821

Mailing address

14371 Fridley Way
Apple Valley, MN 55124-5085
Phone (651) 260-7252

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
I20240118000155 MN Practitioner - Mental Health Counselor 9234581992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

17685 Juniper Path
Suite 303
Lakeville, MN 55044-9821
Phone (952) 214-8959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3045MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jan 1, 2024 Accepting new patients

Locations

17685 Juniper Path
Ste 303
Lakeville, MN 55044
Phone (952) 214-8959

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1669061230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14371 FRIDLEY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245085",
            "telephone_number": "651-260-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17685 JUNIPER PATH STE 301",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449821",
            "telephone_number": "651-628-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.