Individual provider Active NPI

Jayna Lundgren

  • Mental Health Counselor
  • Eagan, MN
National Provider Identifier
1841949476
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4660 Slater Rd Ste 120
Eagan, MN 55122-4048
Phone
(651) 492-1096
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4660 Slater Rd Ste 120
Eagan, MN 55122-4048

Mailing address

5600 Camerata Way Unit 316
St Louis Park, MN 55416-5290
Phone (651) 492-1096

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

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1841949476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 CAMERATA WAY UNIT 316",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165290",
            "telephone_number": "651-492-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 SLATER RD STE 120",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224048",
            "telephone_number": "651-492-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "JAYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.