Active NPI
Adam Gierok, PSYD
- Forensic Psychologist
- Minneapolis, MN
National Provider Identifier
1124643408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- LP5956
- Practice address
- 1516 W Lake St Ste 110
Minneapolis, MN 55408-2554 - Phone
- (612) 822-1357
- Fax
- (612) 822-1360
- NPI assigned
- Jun 11, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | LP5956 | MN | Primary |
Addresses
Primary practice location
1516 W Lake St Ste 110
Minneapolis, MN 55408-2554
Mailing address
2712 Fremont Ave S
Minneapolis, MN 55408-1122
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5956 | MN | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591833600000",
"number": "1124643408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2712 FREMONT AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554081122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 W LAKE ST STE 110",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082554",
"telephone_number": "612-822-1357",
"fax_number": "612-822-1360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIEROK",
"first_name": "ADAM",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-11",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MN",
"license": "LP5956",
"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 Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.