Sarallyn Marie Gumke, MSW, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

32196 Issued in MN

Practice address

299 Coon Rapids Blvd NW
Coon Rapids, MN 55433-5832

Phone

(763) 732-9851

NPI assigned

Jun 20, 2023

Sex

Female

Sole proprietor

Yes

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.

• Vayda Mental Health Collaborative PLLC

  • Clinical Psychologist
  • Coon Rapids, MN
  • NPI 1770194417
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 20, 2023.

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1417632001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335832",
            "telephone_number": "763-732-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335832",
            "telephone_number": "763-732-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMKE",
        "first_name": "SARALLYN",
        "middle_name": "MARIE",
        "credential": "MSW, LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "32196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John H Gryte, MD
• Guardian Angel LLC
• Samantha Marie Gudgeon, NURSE PRACTITIONER
• Taylor Guernsey, MS, LPCC
• Anne Margaret Guiral, RN, CNP
• Adam Lee Gunder, M.D.
• Preeti Gupta, DDS
• Katherine Wolf Gurchak, M.D.
• William C Gustafson, D.C.
• Alejandra Gutierrez Bernal, M.D.

• All providers in Coon Rapids, MN
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.