Individual provider Active NPI

Roberta Lynn Gerling, PSYD, LP

  • Counseling Psychologist
  • Eden Prairie, MN
National Provider Identifier
1164560934
Registry record updated Nov 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP5808 Issued in MN
Practice address
6400 Flying Cloud Dr Ste 180
Eden Prairie, MN 55344-3337
Phone
(952) 217-3412
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP5808 MN Primary

Addresses

Primary practice location

6400 Flying Cloud Dr Ste 180
Eden Prairie, MN 55344-3337

Mailing address

1212 Crystal Place E.
Chaska, MN 55318
Phone (952) 217-3412

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
I20141212001259 MN Practitioner - Clinical Psychologist 0143542548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6400 Flying Cloud Dr
Suite 180
Eden Prairie, MN 55344-3329
Phone (952) 217-3412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP5808MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Roberta Gerling LLC CurrentSince May 28, 2017 Accepting new patients

Locations

6400 Flying Cloud Dr
Ste 180
Eden Prairie, MN 55344
Phone (612) 812-7857

16204 Highway 7
Minnetonka, MN 55345
Phone (612) 293-8564

Organizations & group practices 1

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1164560934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 CRYSTAL PLACE E.",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "55318",
            "telephone_number": "952-217-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FLYING CLOUD DR STE 180",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443337",
            "telephone_number": "952-217-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLING",
        "first_name": "ROBERTA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP5808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.