Active NPI
Gambler'S Relief
- Psychologist
- Burnsville, MN
National Provider Identifier
1225308786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP3228
- Legal business name
- GAMBLER'S RELIEF
- Practice address
- 2960 Judicial Rd
210
Burnsville, MN 55337-5507 - Phone
- (952) 224-2990
- Fax
- (952) 224-2990
- NPI assigned
- Dec 30, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ruth Russo
- Title
- Business Office Manager
- Phone
- (952) 224-2990
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 302633 | MN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Psychologist | 103T00000X | LP3228 | MN | Primary |
Addresses
Primary practice location
2960 Judicial Rd
210
Burnsville, MN 55337-5507
Mailing address
2960 Judicial Rd
210
Burnsville, MN 55337-5507
Phone (952) 224-2990
National Provider Directory
National Provider DirectoryLocations
2960 Judicial Rd
Ste 210
Burnsville, MN 55337
Phone (952) 224-2990
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Burnsville, MN
- NPI 1376988857
-
- Counseling Psychologist
- Burnsville, MN
- NPI 1114925468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1325203200000",
"number": "1225308786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 JUDICIAL RD",
"address_2": "210",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553375507",
"telephone_number": "952-224-2990",
"fax_number": "952-224-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 JUDICIAL RD",
"address_2": "210",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553375507",
"telephone_number": "952-224-2990",
"fax_number": "952-224-2990"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GAMBLER'S RELIEF",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-30",
"last_updated": "2011-12-30",
"status": "A",
"authorized_official_last_name": "RUSSO",
"authorized_official_first_name": "RUTH",
"authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
"authorized_official_telephone_number": "952-224-2990"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "302633",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MN",
"license": "LP3228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.