Organization Active NPI

Peaceofmind Psychiatry & Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Blaine, MN
National Provider Identifier
1891586582
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PEACEOFMIND PSYCHIATRY & WELLNESS LLC
Practice address
1521 93Rd LN NE Ste 100
Blaine, MN 55449-4432
Phone
(612) 598-3937
NPI assigned
May 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Agnes Limunga Jackai, APRN, CNP, PMHNP-BCNPI 1891403135
Title
Nurse Practitioner
Phone
(612) 598-3937

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)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1521 93Rd LN NE Ste 100
Blaine, MN 55449-4432

Mailing address

1521 93Rd LN NE Ste 100
Blaine, MN 55449-4432
Phone (612) 598-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250811003003 MN Part B Supplier - Clinic/Group Practice 9638677412 Receives reassigned benefits from 1 practitioner
Practice locations: Blaine, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1891586582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 93RD LN NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494432",
            "telephone_number": "612-598-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 93RD LN NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494432",
            "telephone_number": "612-598-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEOFMIND PSYCHIATRY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "JACKAI",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "LIMUNGA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "612-598-3937",
        "authorized_official_credential": "APRN, CNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.