Active NPI
Jennifer Lynd Mosey Gustafson, LMFT
- Marriage & Family Therapist
- Richfield, MN
National Provider Identifier
1801037601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1710
- Practice address
- 6425 Nicollet Ave
Richfield, MN 55423-1675 - Phone
- (612) 798-8167
- Fax
- (612) 861-3446
- NPI assigned
- Mar 9, 2009
- 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 | 1710 | MN | Primary |
Addresses
Primary practice location
6425 Nicollet Ave
Richfield, MN 55423-1675
Mailing address
12758 Diamond Path
Apple Valley, MN 55124-8375
Phone (612) 619-6887
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 |
|---|---|---|---|
| 1710 | MN | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1801037601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12758 DIAMOND PATH",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551248375",
"telephone_number": "612-619-6887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6425 NICOLLET AVE",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554231675",
"telephone_number": "612-798-8167",
"fax_number": "612-861-3446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "JENNIFER",
"middle_name": "LYND MOSEY",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.