Kathleen Gehring Anderson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

01976 Issued in MN

Practice address

3033 Excelsior Blvd
Minneapolis, MN 55416-4688

Phone

(612) 547-9990

Fax

(651) 925-0427

NPI assigned

Sep 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lyn-Lake Psychotherapy and Wellness LTD.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1609355163

  Mental Health

  NPD

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1407339005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4746 CLEARWATER CIR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553785623",
            "telephone_number": "952-440-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164688",
            "telephone_number": "612-547-9990",
            "fax_number": "651-925-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHLEEN",
        "middle_name": "GEHRING",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Andreas Anderson, RN,DNP, CRNA
• Kajsa Anderson, MD
• Kali B Anderson, L.I.C.S.W.
• Karl Andrew Anderson, OT
• Kathleen Anderson, PT
• Kathryn Brooke Anderson, MD, PHD
• Kim Alan Anderson, PT
• Kyle James Anderson
• Larry L Anderson, PSYD
• Lily Anderson, PT, DPT

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.