Active NPI
Gerard David Lasalle, MS LP
- Psychologist
- Lakeville, MN
National Provider Identifier
1700944675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP1359
- Practice address
- 17305 Cedar Ave South
Suite 230
Lakeville, MN 55044 - Phone
- (952) 435-4144
- Fax
- (952) 435-4149
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP1359 | MN | Primary |
Addresses
Primary practice location
17305 Cedar Ave South
Suite 230
Lakeville, MN 55044
Mailing address
7486 157TH St W
#103
Apple Valley, MN 55124
Phone (507) 581-1800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 826T5LA | Other | MN | BCBS |
| 11047315 | Other | MN | PREFERRED ONE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1359 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burnsville Counseling & Healing Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Lakeville, MN
- NPI 1518963750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700944675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7486 157TH ST W",
"address_2": "#103",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "55124",
"telephone_number": "507-581-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17305 CEDAR AVE SOUTH",
"address_2": "SUITE 230",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "55044",
"telephone_number": "952-435-4144",
"fax_number": "952-435-4149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASALLE",
"first_name": "GERARD",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MS LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP1359",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "826T5LA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "11047315",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.