Active NPI
Rachel Elizabeth Gardner, M.A., L.P
- Clinical Child & Adolescent Psychologist
- Minneapolis, MN
National Provider Identifier
1376795278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 3333 University Ave SE
Minneapolis, MN 55414-3325 - Phone
- (612) 331-9413
- NPI assigned
- Oct 22, 2008
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | Primary | ||
| Family Psychologist | 103TF0000X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X |
Addresses
Primary practice location
3333 University Ave SE
Minneapolis, MN 55414-3325
Mailing address
3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 331-9413
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fraser | Past | Accepting new patients | |
| Fraser Child and Family Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Richfield, MN
- NPI 1063568574
-
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1609922194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1376795278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 UNIVERSITY AVE SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554143325",
"telephone_number": "612-331-9413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 UNIVERSITY AVE SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554143325",
"telephone_number": "612-331-9413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "RACHEL",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "M.A., L.P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.