Active NPI
Jennifer Haut-Prokop, MA, LMFT
- Marriage & Family Therapist
- Minneapolis, MN
National Provider Identifier
1699540666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4366
- Practice address
- 621 W Lake St Ste 350
Minneapolis, MN 55408-2952 - Phone
- (651) 409-3315
- NPI assigned
- Nov 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4366 | MN | Primary |
Addresses
Primary practice location
621 W Lake St Ste 350
Minneapolis, MN 55408-2952
Mailing address
1792 Hubbard Ave
Saint Paul, MN 55104-1134
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4366 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nobility Wellness Services, PLLC | Marriage & Family Therapist | Past | Accepting new patients |
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.
-
- Adult Mental Health Clinic/Center
- Saint Paul, MN
- NPI 1366908824
Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1699540666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1792 HUBBARD AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551041134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 W LAKE ST STE 350",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082952",
"telephone_number": "651-409-3315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUT-PROKOP",
"first_name": "JENNIFER",
"credential": "MA, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-20",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "4366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.