Active NPI
Stephanie Ann Jenkins, L..P.
- Psychologist
- Minneapolis, MN
National Provider Identifier
1891863890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3440
- Practice address
- 310 Clifton Ave
Minneapolis, MN 55403-3218 - Phone
- (612) 823-7186
- Fax
- (612) 870-1200
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3440 | MN | Primary |
Addresses
Primary practice location
310 Clifton Ave
Minneapolis, MN 55403-3218
Mailing address
4809 Portland Ave
Minneapolis, MN 55417-1033
Phone (612) 823-4041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190509002620 | MN | Practitioner - Psychologist Billing Independently | 8325381544 | Practice locations: Minneapolis, MN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3440 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brenda E Steve Ma LP Incorporated | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counseling Psychologist
- Minneapolis, MN
- NPI 1386202372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891863890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4809 PORTLAND AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171033",
"telephone_number": "612-823-4041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 CLIFTON AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033218",
"telephone_number": "612-823-7186",
"fax_number": "612-870-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "L..P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "3440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.