Gretchen Slavicek, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3882 Issued in MN

Practice address

519 Anne St NW Ste B
Bemidji, MN 56601-4278

Phone

(218) 444-2845

NPI assigned

Jul 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Credentials

Master of Science

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.

• Lakeside Family Wellness LLC

  • Marriage & Family Therapist
  • Osage, MN
  • NPI 1205714409
  Medicare reassignment NPD Authorized official
• Stellher Human Services, Inc.

  • Community/Behavioral Health Agency
  • Bemidji, MN
  • NPI 1023225430
  Medicare reassignment NPD

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1194498386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566190430",
            "telephone_number": "218-444-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 ANNE ST NW STE B",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014278",
            "telephone_number": "218-444-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVICEK",
        "first_name": "GRETCHEN",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Skipton, PT
• Neil A Skogerboe, MD
• Logan Slack
• Lyndsey Slade
• Sydney Grace Slagter
• Michael Tillman Sletta, MSW, LICSW
• Christopher Lee Slough
• Ashley N Smith, MSW, LGSW
• Blake Daniel Smith, D.D.S.
• Bradley A Smith, PA-C

• Marriage & Family Therapist in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.