Penny Giesbrecht, PSYD LP PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP3788 Issued in MN

Legal business name

PENNY GIESBRECHT, PSYD LP PA

Practice address

521 Tanglewood Dr
Shoreview, MN 55126-2016

Phone

(651) 486-0122

Fax

(651) 481-8661

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Penny Sue Giesbrecht, PSY.D.NPI 1396830758

Title

L.P.

Phone

(651) 485-2842

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Penny Sue Giesbrecht, PSY.D., L.P.

  • Clinical Psychologist
  • Shoreview, MN
  • NPI 1396830758
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1699811752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 TANGLEWOOD DR",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262016",
            "telephone_number": "651-486-0122",
            "fax_number": "651-481-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 TANGLEWOOD DR",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262016",
            "telephone_number": "651-486-0122",
            "fax_number": "651-481-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNY GIESBRECHT, PSYD LP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "GIESBRECHT",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "L.P.",
        "authorized_official_telephone_number": "651-485-2842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "925015800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHP",
            "identifier": "2103601",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6191037",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50Q60GI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jigna Patel
• Pathway Virtu-Health
• Sejal S Peckosh, PA
• Kristen Joy Pederson, LISW
• Rachel Marie Pelzer
• Reynaldo Jorge Pereira, SURGICAL ASSISTANT
• Gregory K Peters, MD
• Caleb Petersen, LAMFT
• Mae Petrangelo, MS,CCC-SLP
• Rebecca Lea Pilet, MOT, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.