Individual provider Active NPI

Jennifer Anne Schroeder, LPCC

  • Professional Counselor
  • Maplewood, MN
National Provider Identifier
1871187518
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
02190 Issued in MN
Practice address
2001 Beam Ave
Maplewood, MN 55109-1401
Phone
(612) 446-3926
NPI assigned
Feb 23, 2021
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 02190 MN Primary

Addresses

Primary practice location

2001 Beam Ave
Maplewood, MN 55109-1401

Mailing address

2001 Beam Ave
Maplewood, MN 55109-1401
Phone (612) 446-3926

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
I20241014002999 MN Practitioner - Mental Health Counselor 6204368368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

12915 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (952) 826-8475

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02190MNMDProfessional Counselor
2190MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC CurrentSince Aug 2, 2024 Accepting new patients
Prairiecare LLC PastSince Mar 4, 2021 Accepting new patients

Locations

2001 Beam Ave
Maplewood, MN 55109
Phone (952) 737-4500

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1871187518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091401",
            "telephone_number": "612-446-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091401",
            "telephone_number": "612-446-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.