Individual provider Active NPI

Jennifer Oliver-King, LMFT

  • Marriage & Family Therapist
  • Maple Grove, MN
National Provider Identifier
1861426942
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 1526 Issued in MN
Practice address
7026 E Fish Lake Rd
Maple Grove, MN 55311-2832
Phone
(612) 239-5055
Fax
(763) 424-8315
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT 1526 MN Primary

Addresses

Primary practice location

7026 E Fish Lake Rd
Maple Grove, MN 55311-2832

Mailing address

7026 E Fish Lake Rd
Maple Grove, MN 55311-2832
Phone (612) 239-5055

Other identifiers 3

IdentifierTypeStateIssuer
374896100MedicaidMN
HP59862OtherMNHEALTH PARTNERS
906590LOtherMNBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240329000112 MN Practitioner - Marriage and Family Therapist 4789022591 Practice locations: Maple Grove, MN

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7026 E Fish Lake Rd
Maple Grove, MN 55311-2832
Phone (612) 239-5055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1526MNMDPsychologist
LMFT 1526MNMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1861426942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 E FISH LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112832",
            "telephone_number": "612-239-5055",
            "fax_number": "763-424-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7026 E FISH LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112832",
            "telephone_number": "612-239-5055",
            "fax_number": "763-424-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER-KING",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT 1526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374896100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP59862",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "906590L",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.