Fireside Counseling LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 4675 Issued in MN

Legal business name

FIRESIDE COUNSELING LLC

Practice address

9352 Oak Ave
Waconia, MN 55387-9422

Phone

(952) 373-1279

Fax

(844) 762-3234

NPI assigned

Feb 24, 2012

Organization subpart

No

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

Authorized official

Name

Gary Joseph Freitas, PHDNPI 1679598072

Title

Owner, Licensed Psychologist

Phone

(952) 373-1279

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

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

• Gary Joseph Freitas, PH.D., LP

  • Psychologist
  • Chanhassen, MN
  • NPI 1679598072
  Medicare reassignment NPD Authorized official
• Kay Nordgren, LPCC

  • Professional Counselor
  • Waconia, MN
  • NPI 1225434426
  NPD
• Alexa Vansickle, MA, LPCC

  • Professional Counselor
  • Waconia, MN
  • NPI 1508669110
  NPD
• Andrea Kileen Egli, PH.D. L.P.

  • Clinical Psychologist
  • Waconia, MN
  • NPI 1205105632
  NPD (past)
• Clayton Joseph Egli, PH.D.

  • Clinical Psychologist
  • Waconia, MN
  • NPI 1154699015
  NPD (past)
• Sally Sparby, MA, LPCC, LADC

  • Mental Health Counselor
  • Waconia, MN
  • NPI 1528417862
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1447524285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9352 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422",
            "telephone_number": "952-270-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422",
            "telephone_number": "952-373-1279",
            "fax_number": "844-762-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRESIDE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "FREITAS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER, LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "952-373-1279",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 4675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "680002139",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Feriancek, D.C.
• Spencer R Ferrell, MD
• Evan Fillingane
• Jennifer R Finger
• Abigail Finnegan
• Sara Fish, M.D.
• Emily Flack
• Katrina Flaskerud, MS, RD, LD
• Michelle Lynn Flaskerud, CNP
• Jane Marie Fleming, MSW

• Psychologist in Waconia, MN
• Providers in Waconia, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.