Organization Active NPI

Gurganus Psychological Services, LLC

  • Clinical Psychologist
  • Edina, MN
National Provider Identifier
1316910383
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4536 Issued in MN
Legal business name
GURGANUS PSYCHOLOGICAL SERVICES, LLC
Practice address
7241 Ohms Lane
Suite 145
Edina, MN 55439-2136
Phone
(952) 920-0711
Fax
(952) 920-0716
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
Dr. Sara Lea Gurganus, PSY.D., L.P.
Title
Owner
Phone
(952) 920-0711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X LP4536 MN Primary

Addresses

Primary practice location

7241 Ohms Lane
Suite 145
Edina, MN 55439-2136

Mailing address

7241 Ohms Lane
Suite 145
Edina, MN 55439-2136
Phone (952) 920-0711

National Provider Directory

National Provider Directory

Locations

4010 W 65th St
Ste 220
Edina, MN 55435
Phone (952) 920-0711

7241 Ohms Ln
Ste 145
Edina, MN 55439
Phone (952) 920-0711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1316910383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7241 OHMS LANE",
            "address_2": "SUITE 145",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392136",
            "telephone_number": "952-920-0711",
            "fax_number": "952-920-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 OHMS LANE",
            "address_2": "SUITE 145",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392136",
            "telephone_number": "952-920-0711",
            "fax_number": "952-920-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURGANUS PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "GURGANUS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-920-0711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., L.P."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.