Active NPI
Gay Rosenthal, M.A., L.P.
- Clinical Child & Adolescent Psychologist
- Minneapolis, MN
National Provider Identifier
1063518306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- LP1844
- Practice address
- 15 Groveland Terrace
Suite 305
Minneapolis, MN 55403 - Phone
- (952) 930-7546
- Fax
- (612) 374-4661
- NPI assigned
- Sep 15, 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | LP1844 | MN | Primary |
Addresses
Primary practice location
15 Groveland Terrace
Suite 305
Minneapolis, MN 55403
Mailing address
17538 70TH Place North
Maple Grove, MN 55311
Phone (763) 496-1151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1844 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063518306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17538 70TH PLACE NORTH",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "55311",
"telephone_number": "763-496-1151",
"fax_number": "763-496-1307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 GROVELAND TERRACE",
"address_2": "SUITE 305",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55403",
"telephone_number": "952-930-7546",
"fax_number": "612-374-4661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "GAY",
"name_prefix": "Ms.",
"credential": "M.A., L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "LP1844",
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.