Luann Gravelle, CFPS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

112 Highway 371 S
Hackensack, MN 56452-2638

Phone

(218) 675-5101

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Birch Lake Counseling LLC

  • Clinic/Center
  • Hackensack, MN
  • NPI 1760646715
  NPD (past)

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1669036968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 28TH AVE SW",
            "city": "BACKUS",
            "state": "MN",
            "postal_code": "564352328",
            "telephone_number": "612-940-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HIGHWAY 371 S",
            "city": "HACKENSACK",
            "state": "MN",
            "postal_code": "564522638",
            "telephone_number": "218-675-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELLE",
        "first_name": "LUANN",
        "credential": "CFPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryana Cook, MSW, LGSW
• Rachal Aasa Cross, LGSW
• Jennifer A Dalgarno, PA
• Linnea Frances Dietrich, LMFT
• Faith in Action for Cass County
• Carol Ellen Horsager, MED, LMFT
• Paula Marie Schroeder, LSW
• St. Joseph's Medical Center (Essentia Health St. Joseph's - Hackensack Clinic)
• St. Joseph's Medical Center (Essentia Health St. Joseph's-Hackensack Clinic)
• Sue Ann Stewart, CFPS

• Peer Specialist in Hackensack, MN
• Providers in Hackensack, MN by specialty
• Peer Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.