Active NPI
Jennifer Born, Psy.D., Licensed Psychologist, LLC
- Counseling Psychologist
- Saint Paul, MN
National Provider Identifier
1881986065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP5098
- Legal business name
- JENNIFER BORN, PSY.D., LICENSED PSYCHOLOGIST, LLC
- Practice address
- 1595 Selby Ave
Suite 106
Saint Paul, MN 55104 - Phone
- (651) 600-2011
- NPI assigned
- May 6, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jennifer Born, PSY.D., LP
- Title
- Owner
- Phone
- (952) 250-1390
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP5098 | MN | Primary |
Addresses
Primary practice location
1595 Selby Ave
Suite 106
Saint Paul, MN 55104
Mailing address
1595 Selby Ave
Suite 106
Saint Paul, MN 55104
Phone (651) 600-2011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 073645000 | Medicaid | MN |
National Provider Directory
National Provider DirectoryLocations
1595 Selby Ave
Ste 106
Saint Paul, MN 55104
Phone (651) 600-2011
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Minneapolis, MN
- NPI 1760611933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304640000000",
"number": "1881986065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 SELBY AVE",
"address_2": "SUITE 106",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "55104",
"telephone_number": "651-600-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 SELBY AVE",
"address_2": "SUITE 106",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "55104",
"telephone_number": "651-600-2011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JENNIFER BORN, PSY.D., LICENSED PSYCHOLOGIST, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A",
"authorized_official_last_name": "BORN",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "952-250-1390",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY.D., LP"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP5098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "073645000",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
- Jenna Schuder, Inc
- Ann E Jennen, D.D.S.
- Sara Elizabeth Jennerjohn
- Jennie Hardman Therapy
- Jennie Yngsdahl , Ma, Licensed Psychologist, LLC (Center for Counseling and Wellness)
- Jennings Community Learning Center
- Jennings Community Learning Center
- Ashley Fee Jennings, PHD
- Jenny Decker LLC
- Camille Jo Jensen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.