Madeline Gebhard, LICSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20482 Issued in MN

Practice address

10799 Falling Water LN Unit D
Woodbury, MN 55129-5263

Phone

(323) 333-9511

NPI assigned

Feb 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1184487936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10799 FALLING WATER LN UNIT D",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551295263",
            "telephone_number": "323-333-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10799 FALLING WATER LN UNIT D",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551295263",
            "telephone_number": "323-333-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHARD",
        "first_name": "MADELINE",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MN",
            "license": "20482",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CO",
            "license": "CSW.09928484",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Gavin, MSW, LICSW
• William Gavin, D.D.S.
• Abiola Gbala
• Lindsey Rose Gear
• El Shadai A Gebe
• Amanda Rachel Gebhardt-Fitzgerald, DC
• Laurie Geddes, MS, PMHNP
• Hani Geele
• Jeffrey Geiger, PT, DPT
• Patricia Kay Geisen, FNP-C

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.