Active NPI
Gayle L. Kittleson, LMFT
- Marriage & Family Therapist
- Mendota Heights, MN
National Provider Identifier
1245589274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1408
- Practice address
- 1385 Mendota Heights Rd
Suite 200
Mendota Heights, MN 55120-1368 - Phone
- (651) 379-9800
- Fax
- (651) 405-0358
- NPI assigned
- Sep 6, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1408 | MN | Primary |
Addresses
Primary practice location
1385 Mendota Heights Rd
Suite 200
Mendota Heights, MN 55120-1368
Mailing address
2502 Taylor Ave
White Bear Township, MN 55110-5741
Phone (651) 762-0998
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 |
|---|---|---|---|
| 1408 | MN | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Adolescents and Children Therapy Services Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Eagan, MN
- NPI 1518053834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1245589274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2502 TAYLOR AVE",
"city": "WHITE BEAR TOWNSHIP",
"state": "MN",
"postal_code": "551105741",
"telephone_number": "651-762-0998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1385 MENDOTA HEIGHTS RD",
"address_2": "SUITE 200",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551201368",
"telephone_number": "651-379-9800",
"fax_number": "651-405-0358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTLESON",
"first_name": "GAYLE",
"middle_name": "L.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mendota Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.