Denise Rose Gudvangen, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3957 Issued in MN

Practice address

603 Bruce St
Crookston, MN 56716

Phone

(218) 281-3940

Fax

(218) 281-6261

NPI assigned

Mar 16, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Denise Jadeke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508835141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "address_2": "PO BOX 603",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567160603",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "56716",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDVANGEN",
        "first_name": "DENISE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "3957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP28754",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "123671",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "41B43JA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "JADEKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Braydon Gourneau
• Michael A Graner, LADC
• Great Plains EMS, Inc.
• Christopher J Green, MSW, LICSW
• Amanda Grzadzielewski
• Wayne Scott Halvorson
• Denise Elaine Hammer, LICSW
• Curtis Lee Hamre, LADC
• Molly Hanson, MOTR/L
• Angelica Lynn Hardy

• Clinical Psychologist in Crookston, MN
• Providers in Crookston, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.