Individual provider Active NPI

Grace Emmaline Gilbertson

  • Marriage & Family Therapist
  • St Louis Park, MN
National Provider Identifier
1093445959
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
7601 Wayzata Blvd
St Louis Park, MN 55426-1623
Phone
(612) 223-8898
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 Primary

Addresses

Primary practice location

7601 Wayzata Blvd
St Louis Park, MN 55426-1623

Mailing address

7601 Wayzata Blvd
St Louis Park, MN 55426-1623

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250506003224 MN Practitioner - Marriage and Family Therapist 5496272197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

3601 Minnesota Dr
Suite 575
Edina, MN 55435-5213
Phone (612) 223-8898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4540MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients
Optum Behavioral Care of Colorado PC CurrentSince Apr 15, 2025 Accepting new patients
Care Clinics, LLC CurrentSince Feb 11, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 15, 2025 Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

3601 Minnesota Dr
Ste 575
Minneapolis, MN 55435
Phone (612) 799-8975

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1093445959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261623",
            "telephone_number": "612-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "GRACE",
        "middle_name": "EMMALINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.