Individual provider Active NPI

Gail Joyce Schulstrom, MSW, LICSW

  • Social Worker
  • Minnetonka, MN
National Provider Identifier
1659681856
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
#3941 Issued in MN
Practice address
12601 Ridgedale Drive, Ridgedale Service Center
Hennepin County Children'S Mental Health Crisis Service
Minnetonka, MN 55305
Phone
(612) 348-8801
Fax
(952) 541-6270
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X #3941 MN Primary

Addresses

Primary practice location

12601 Ridgedale Drive, Ridgedale Service Center
Hennepin County Children'S Mental Health Crisis Service
Minnetonka, MN 55305

Mailing address

12601 Ridgedale Drive Ridgedale Service Center
Hennepin County Children'S Mental Health Crisis Service
Minnetonka, MN 55305
Phone (612) 348-8801

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
#3941MNMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1659681856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12601 RIDGEDALE DRIVE RIDGEDALE SERVICE CENTER",
            "address_2": "HENNEPIN COUNTY CHILDREN'S MENTAL HEALTH CRISIS SERVICE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "612-348-8801",
            "fax_number": "952-541-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 RIDGEDALE DRIVE, RIDGEDALE SERVICE CENTER",
            "address_2": "HENNEPIN COUNTY CHILDREN'S MENTAL HEALTH CRISIS SERVICE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "612-348-8801",
            "fax_number": "952-541-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULSTROM",
        "first_name": "GAIL",
        "middle_name": "JOYCE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "#3941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.