Individual provider Active NPI

Therese Marie Kohs Gilbertson, M.A., L.P.

  • Psychologist
  • Shoreview, MN
National Provider Identifier
1215001136
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP0422 Issued in MN
Practice address
4175 Nancy PL
Shoreview, MN 55126-6411
Phone
(651) 308-2272
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP0422 MN Primary

Addresses

Primary practice location

4175 Nancy PL
Shoreview, MN 55126-6411

Mailing address

4175 Nancy PL
Shoreview, MN 55126-6411
Phone (651) 308-2272

Other practice location 1

2150 Radio Dr
Woodbury, MN 55125-9453
Phone (651) 275-8714

Other identifiers 1

IdentifierTypeStateIssuer
118552700MedicaidMN

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
I20260309000041 MN Practitioner - Clinical Psychologist 2062994254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Applied Care Services IncGroup PAC ID 2769978212, 7 clinicians

Practice addresses (Care Compare)

6600 Lyndale Ave S
Suite 110
Richfield, MN 55423-3398
Phone (612) 229-3519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP0422MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Care Services, Inc. CurrentSince Jan 5, 2026 Accepting new patients

Locations

6600 Lyndale Ave S
Ste 110
Richfield, MN 55423
Phone (612) 205-5332

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1215001136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 NANCY PL",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551266411",
            "telephone_number": "651-308-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 NANCY PL",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551266411",
            "telephone_number": "651-308-2272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Radio Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551259453",
            "country_code": "US",
            "telephone_number": "651-275-8714",
            "fax_number": "541-275-8723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHS GILBERTSON",
        "first_name": "THERESE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118552700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

Verify at the official NPI Registry.