Individual provider Active NPI

Karen Jeffords-Brown, M.A., LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1831103142
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1793 Issued in MN
Practice address
1928 Berkeley Ave
Saint Paul, MN 55105-1630
Phone
(612) 840-4138
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1793 MN Primary

Addresses

Primary practice location

1928 Berkeley Ave
Saint Paul, MN 55105-1630

Mailing address

1928 Berkeley Ave
Saint Paul, MN 55105-1630
Phone (612) 840-4138

Other identifiers 1

IdentifierTypeStateIssuer
446750700MedicaidMN

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

LicenseStateTypeSpecialty
1793MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1831103142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 BERKELEY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051630",
            "telephone_number": "612-840-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 BERKELEY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051630",
            "telephone_number": "612-840-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFORDS-BROWN",
        "first_name": "KAREN",
        "credential": "M.A., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "1793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "446750700",
            "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 Dec 22, 2010; 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.