Rachael Leanne Gardner, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4414 Issued in MN

Practice address

17685 Juniper Path Ste 303
Lakeville, MN 55044-9821

Phone

(952) 214-8959

Fax

(952) 214-8960

NPI assigned

Dec 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wild Tree Psychotherapy LLCGroup PAC ID 8426408881, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wild Tree Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1528451408
  Medicare reassignment Care Compare group NPD
• Sarah C. Chambers, P.a.

  • Health Service Clinic/Center
  • Saint Paul, MN
  • NPI 1942358379
  NPD (past)

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1093427916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17685 JUNIPER PATH STE 303",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17685 JUNIPER PATH STE 303",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449821",
            "telephone_number": "952-214-8959",
            "fax_number": "952-214-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "RACHAEL",
        "middle_name": "LEANNE",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306133",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Grace Malone Frentz, DDS
• Kyle Froeber
• Allison Jo Gadient, DNP, APRN, FNP-C
• Jocelyn Gamble
• Patricia Gannon, MPH, CNP
• Chaltu Bedane Gashu
• Jeanne Marcia Gau, DDS MS
• Zhen Hua Geng, MD
• Kristen Gerlach, PT
• Robbin Dale Ghere, PA-C

• Professional Counselor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.