Individual provider Active NPI

Aja Dionna King, ED.D.

  • Mental Health Counselor
  • Brooklyn Park, MN
National Provider Identifier
1821423740
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
944 Issued in MN
Practice address
6312 Welcome Ave N
Brooklyn Park, MN 55429-2047
Phone
(205) 451-7955
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X
Mental Health Counselor 101YM0800X 944 MN Primary

Addresses

Primary practice location

6312 Welcome Ave N
Brooklyn Park, MN 55429-2047

Mailing address

6312 Welcome Ave N
Brooklyn Park, MN 55429-2047
Phone (205) 451-7955

Other practice location 1

227 Colfax Ave N Ste 15
Minneapolis, MN 55405
Phone (612) 223-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241108001895 MN Practitioner - Mental Health Counselor 2466986757 Reassigns benefits to 2 organizations
I20251122000610 FL Practitioner - Mental Health Counselor 2466986757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Oct 12, 2024 Accepting new patients
Brave Defiance Consulting LLC Counseling CurrentSince Feb 18, 2024 Accepting new patients
Empower Therapeutic Support Services PLLC Mental Health Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1821423740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 WELCOME AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554292047",
            "telephone_number": "205-451-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 WELCOME AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554292047",
            "telephone_number": "205-451-7955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 Colfax Ave N Ste 15",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55405",
            "country_code": "US",
            "telephone_number": "612-223-0373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "AJA",
        "middle_name": "DIONNA",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.