Active NPI
Pamela June Gusdal, MT-BC
- Music Therapist
- St Louis Park, MN
National Provider Identifier
1164631123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 03886
- Practice address
- 3630 Phillips Pkwy
St Louis Park, MN 55426-3792 - Phone
- (952) 939-1606
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 03886 | MN | Primary |
Addresses
Primary practice location
3630 Phillips Pkwy
St Louis Park, MN 55426-3792
Mailing address
9005 W 34TH St
St Louis Park, MN 55426-3703
Phone (612) 423-6523
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 |
|---|---|---|---|
| 03886 | MN | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164631123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9005 W 34TH ST",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554263703",
"telephone_number": "612-423-6523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 PHILLIPS PKWY",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554263792",
"telephone_number": "952-939-1606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSDAL",
"first_name": "PAMELA",
"middle_name": "JUNE",
"name_prefix": "Ms.",
"credential": "MT-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "MN",
"license": "03886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.