Individual provider Active NPI

Kristen Jurgenson, LMFT

  • Marriage & Family Therapist
  • Phoenix, AZ
National Provider Identifier
1801494133
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT-15517 Issued in AZ
Practice address
12835 N 32ND St
Phoenix, AZ 85032-6517
Phone
(602) 685-6000
Fax
(602) 992-6209
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT-15517 AZ Primary

Addresses

Primary practice location

12835 N 32ND St
Phoenix, AZ 85032-6517

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118004544 AZ Practitioner - Marriage and Family Therapist 7214389899 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT-15517AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1919 E Thomas Rd
Ste Ambbldg
Phoenix, AZ 85016

1919 E Thomas Rd
Ste Amb
Phoenix, AZ 85016

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

5983 E Grant Rd
Ste 117
Tucson, AZ 85712
Phone (520) 320-7999

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1801494133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12835 N 32ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850326517",
            "telephone_number": "602-685-6000",
            "fax_number": "602-992-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURGENSON",
        "first_name": "KRISTEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT-15517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.