Jennifer Jacqueline Felinski Kurtz-Port, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4792 Issued in MN

Practice address

20397 Greengate CT
Lakeville, MN 55044-4877

Phone

(612) 247-3314

Fax

(952) 898-1976

NPI assigned

Jan 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1780214601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20397 GREENGATE CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444877",
            "telephone_number": "612-247-3314",
            "fax_number": "952-898-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20397 GREENGATE CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444877",
            "telephone_number": "612-247-3314",
            "fax_number": "952-898-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ-PORT",
        "first_name": "JENNIFER",
        "middle_name": "JACQUELINE FELINSKI",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4792",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP4792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "952-898-1976",
            "affiliation": "N",
            "endpointDescription": "Fax Machine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Records",
            "address_1": "16688 Kentucky Ave",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550444616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "952-898-1976",
            "affiliation": "N",
            "endpointDescription": "Fax machine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Records",
            "address_1": "20397 Greengate Ct",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550444877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Psychologist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.