Jennie Enstad Psy.D.,L.P. Psychological Services LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

JENNIE ENSTAD PSY.D.,L.P. PSYCHOLOGICAL SERVICES LLC

Practice address

2006 1St Ave Ste 101
Anoka, MN 55303-2255

Phone

(763) 355-4688

NPI assigned

Oct 4, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Enstad, PSY.DNPI 1093725467

Title

Licensed Psychologist

Phone

(763) 355-4468

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer G Enstad, PSY.D., L.P.

  • Counseling Psychologist
  • Maple Grove, MN
  • NPI 1093725467
  Medicare reassignment NPD Authorized official
• Rhonda Mae Burns Johnson, MSW, LICSW

  • Clinical Social Worker
  • Anoka, MN
  • NPI 1285667055
  NPD

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1831664937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17730 GIBBON ST NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553035510",
            "telephone_number": "763-355-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 1ST AVE STE 101",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032255",
            "telephone_number": "763-355-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIE ENSTAD PSY.D.,L.P. PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "ENSTAD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "763-355-4468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263653100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Bagley Jackson, M.D.
• Amanda Rae James, RN
• Jeromy Jaquez
• Kim Jasicki
• Christina Rae Jellison
• Christina Jensen
• Leland Royal Jensen, ADC-T
• Jodi Jenson, COTA/L
• John Louis Jesme, D.C.
• John J Keller DDS PA

• Counseling Psychologist in Anoka, MN
• Providers in Anoka, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.