1. Home
  2. Directory
  3. Minnesota
  4. Brooklyn Park
  5. Marriage Family Therapist
  6. NPI Profile

JACLYN MAE KENNEDY LMFT
NPI 1922876317
Marriage & Family Therapist in Brooklyn Park, MN

Active since December 14, 2023Opted out of Medicare · through Jan 1, 2028
9100 93RD AVE N, BROOKLYN PARK, MN 55445(763) 710-6133 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jaclyn Mae Kennedy Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN MAE KENNEDY LMFT (NPI 1922876317) is an individual marriage & family therapist in Brooklyn Park, Minnesota, licensed in Minnesota (4447) and active in the NPI registry since December 2023. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1922876317
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameJACLYN MAE KENNEDYCredential: LMFT
Location Address9100 93RD AVE NBrooklyn Park, MN 55445-1407
Mailing Address8390 Mississippi Blvd NwCoon Rapids, MN 55433-5938 · (763) 710-6133
Phone(763) 710-6133
Sole ProprietorYes
Enumeration DateDecember 14, 2023
NPPES CertifiedDecember 14, 2023
✔ NPI 1922876317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in MN · 4447
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
9100 93RD AVE N, Brooklyn Park, MN 55445
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jaclyn Mae Kennedy Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Kennedy's NPI number?

The NPI number for Jaclyn Kennedy is 1922876317. It was assigned to this individual provider in the NPPES registry on December 14, 2023.

Where is Jaclyn Kennedy located?

Jaclyn Kennedy practices at 9100 93rd Ave N, Brooklyn Park, MN 55445. The listed phone number is (763) 710-6133.

What is Jaclyn Kennedy's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Jaclyn Kennedy enrolled in Medicare?

No. Jaclyn Kennedy has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jaclyn Kennedy was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.