Gary Edward Stucky, MA/LP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

1575 Issued in MN

Practice address

701 Decatur Ave N
Suite 109
Golden Valley, MN 55427-4367

Phone

(763) 746-2400

Fax

(763) 746-2401

NPI assigned

Jul 23, 2013

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1467894105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DECATUR AVE N",
            "address_2": "SUITE 109",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274367",
            "telephone_number": "763-746-2400",
            "fax_number": "763-746-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DECATUR AVE N",
            "address_2": "SUITE 109",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274367",
            "telephone_number": "763-746-2400",
            "fax_number": "763-746-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKY",
        "first_name": "GARY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MA/LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "1575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.