Individual provider Active NPI

Tessa Gittleman, LMFT

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1073142444
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3573 Issued in MN
Practice address
5851 Duluth St Unit 300
Golden Valley, MN 55422-3946
Phone
(612) 440-8377
Fax
(612) 440-2187
NPI assigned
Apr 7, 2020
Last updated
Dec 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3573 MN Primary

Addresses

Primary practice location

5851 Duluth St Unit 300
Golden Valley, MN 55422-3946

Mailing address

5851 Duluth St Unit 300
Golden Valley, MN 55422-3946
Phone (612) 440-8377

Other names 1

  • Tessa Kai Gittleman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 1, 2024 through Aug 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Birch Counseling, PLLC. PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1073142444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST UNIT 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "612-440-8377",
            "fax_number": "612-440-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST UNIT 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "612-440-8377",
            "fax_number": "612-440-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITTLEMAN",
        "first_name": "TESSA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESSA",
            "last_name": "GITTLEMAN",
            "middle_name": "KAI",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.