Active NPI
Deborah Lynn Gerdes, PSY.D.
- Mental Health Counselor
- Andover, MN
National Provider Identifier
1518244151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC01422
- Practice address
- 13819 Hanson Blvd NW
Andover, MN 55304 - Phone
- (612) 672-6999
- NPI assigned
- Nov 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC01422 | MN | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
13819 Hanson Blvd NW
Andover, MN 55304
Mailing address
3700 W Kilgore Ave
Muncie, IN 47304-4810
Phone (765) 289-5437
Other practice location 1
701 Decatur Ave N Ste 109
Golden Valley, MN 55427-4363
Phone (612) 798-8169
Other practice location 2
3700 W Kilgore Ave
Muncie, IN 47304-4810
Phone (765) 289-5437
Other names 1
- Dr. Deborah Lynn Serber
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC01422 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1518244151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 W KILGORE AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473044810",
"telephone_number": "765-289-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13819 HANSON BLVD NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "55304",
"telephone_number": "612-672-6999"
}
],
"practiceLocations": [
{
"address_1": "701 Decatur Ave N Ste 109",
"address_purpose": "LOCATION",
"city": "Golden Valley",
"state": "MN",
"postal_code": "554274363",
"country_code": "US",
"telephone_number": "612-798-8169",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3700 W Kilgore Ave",
"address_purpose": "LOCATION",
"city": "Muncie",
"state": "IN",
"postal_code": "473044810",
"country_code": "US",
"telephone_number": "765-289-5437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERDES",
"first_name": "DEBORAH",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-10",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC01422",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "SERBER",
"middle_name": "LYNN",
"prefix": "DR.",
"credential": "PSY.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Andover, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.