Active NPI
John Loyal Simensen, LPC
- Professional Counselor
- Minneapolis, MN
National Provider Identifier
1730324161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 00506
- Practice address
- 2809 Wayzata Blvd
Minneapolis, MN 55405-2131 - Phone
- (612) 377-9190
- NPI assigned
- Dec 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 00506 | MN | Primary |
Addresses
Primary practice location
2809 Wayzata Blvd
Minneapolis, MN 55405-2131
Mailing address
4929 Highland Rd
Minnetonka, MN 55345-4616
Phone (612) 810-8225
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00506 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenwood Therapy Center, LLC | 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.
-
- Mental Health Counselor
- Minneapolis, MN
- NPI 1144271230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229299200000",
"number": "1730324161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4929 HIGHLAND RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553454616",
"telephone_number": "612-810-8225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2809 WAYZATA BLVD",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554052131",
"telephone_number": "612-377-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMENSEN",
"first_name": "JOHN",
"middle_name": "LOYAL",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-15",
"last_updated": "2008-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "00506",
"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 Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.