Jennifer Lynn Phoenix, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2888 Issued in MN

Practice address

15030 Zeolite St NW
Ramsey, MN 55303-4301

Phone

(651) 274-9810

NPI assigned

May 24, 2022

Last updated

May 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rum River Counseling, Inc.

  • Marriage & Family Therapist
  • Andover, MN
  • NPI 1073578472
  Medicare reassignment NPD
• Phoenix Rising Therapy, LLC

  • Marriage & Family Therapist
  • Ramsey, MN
  • NPI 1184511628
  NPD Authorized official

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1831837319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 ZEOLITE ST NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034301",
            "telephone_number": "651-274-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 ZEOLITE ST NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034301",
            "telephone_number": "651-274-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOENIX",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Performance Sports Chiropractic Center
• Angel Peterson, RN
• Jamie Lee Peterson, DDS
• Marilyn Kay Peterson, PTA
• Phoenix Rising Therapy, LLC
• Angelique Quinn Piper, M.D.
• Shannon Potter
• Kimberly Putz
• Jennifer Lynn Quade
• R & R Vision, LTD. (Ramsey Eye Clinic)

• Marriage & Family Therapist in Ramsey, MN
• Providers in Ramsey, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.