Active NPI
Jamie McDonell, MA LP
- Counseling Psychologist
- Saint Paul, MN
National Provider Identifier
1760606529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP3798
- Practice address
- 241 Cleveland Ave S
Saint Paul, MN 55105-1208 - Phone
- (651) 699-7051
- Fax
- (651) 699-7052
- NPI assigned
- Apr 12, 2007
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP3798 | MN | Primary |
Addresses
Primary practice location
241 Cleveland Ave S
Saint Paul, MN 55105-1208
Mailing address
241 Cleveland Ave S
Saint Paul, MN 55105-1208
Phone (651) 699-7051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79B63MC | Other | MN | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| LP3798 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1760606529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 CLEVELAND AVE S",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551051208",
"telephone_number": "651-699-7051",
"fax_number": "651-699-7052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 CLEVELAND AVE S",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551051208",
"telephone_number": "651-699-7051",
"fax_number": "651-699-7052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONELL",
"first_name": "JAMIE",
"name_prefix": "Mr.",
"credential": "MA LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP3798",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "79B63MC",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.