Active NPI
Jennifer Marie Nash-Wright, PSYD, LP
- Clinical Psychologist
- Saint Louis Park, MN
National Provider Identifier
1710062765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP3098
- Practice address
- 4027 County Road 25
Saint Louis Park, MN 55416-2629 - Phone
- (612) 925-6033
- Fax
- (612) 925-8496
- NPI assigned
- Oct 26, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP3098 | MN | Primary |
Addresses
Primary practice location
4027 County Road 25
Saint Louis Park, MN 55416-2629
Mailing address
4240 Park Glen Rd
Saint Louis Park, MN 55416-5427
Phone (612) 925-6033
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 441025400 | Medicaid | MN | |
| 61-52076 | Other | MN | UNITED BEHAVIOR HEALTH |
| 7H520NA | Other | MN | BLUECROSSBLUESHEILD |
Other names 1
- Jennifer Marie Nash
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3098 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1710062765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4240 PARK GLEN RD",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554165427",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4027 COUNTY ROAD 25",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554162629",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH-WRIGHT",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP3098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "441025400",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIOR HEALTH",
"identifier": "61-52076",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHEILD",
"identifier": "7H520NA",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "NASH",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.