Individual provider Active NPI

Gretchen Anne Haisman, MA, LAMFT

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1376258475
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
8401 Wayzata Blvd Ste 150
Golden Valley, MN 55426-1377
Phone
(763) 544-1006
NPI assigned
Jan 23, 2023
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

8401 Wayzata Blvd Ste 150
Golden Valley, MN 55426-1377

Mailing address

4877 Bulrush Blvd
Shakopee, MN 55379-5812
Phone (952) 465-5434

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
I20240618000013 MN Practitioner - Marriage and Family Therapist 9830632926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoy and Associates Inc.Group PAC ID 6608318498, 20 clinicians

Practice addresses (Care Compare)

8401 Wayzata Blvd
Suite 150
Golden Valley, MN 55426-1377
Phone (763) 544-1006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4200MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Hoy & Associates Inc. CurrentSince Apr 29, 2024 Accepting new patients

Locations

8401 Wayzata Blvd
Ste 150
Minneapolis, MN 55426
Phone (763) 544-1006

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1376258475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4877 BULRUSH BLVD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795812",
            "telephone_number": "952-465-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 WAYZATA BLVD STE 150",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261377",
            "telephone_number": "763-544-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISMAN",
        "first_name": "GRETCHEN",
        "middle_name": "ANNE",
        "credential": "MA, LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.