Katherine Elyse Gunderson Eccleston, MS, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1741 Issued in MN

Practice address

7954 University Ave NE
Fridley, MN 55432-1860

Phone

(763) 780-3036

Fax

(763) 780-0784

NPI assigned

Feb 14, 2018

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

Practice roles

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.

• Lee Carlson Center for Mental Health and Well-Being

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1457455057
  NPD (past)

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1710487947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 BUCHANAN ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554181450",
            "telephone_number": "612-481-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7954 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321860",
            "telephone_number": "763-780-3036",
            "fax_number": "763-780-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON ECCLESTON",
        "first_name": "KATHERINE",
        "middle_name": "ELYSE",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Green
• Ethan Greenberg, MD
• Sarah Louise Griffin, M.S., C.G.C.
• Bethany Grove, LICSW
• Sacad Guled, MBA
• Courtney Jean Gunderson, LICSW
• Stephanie Marie Gunderson, RN
• Molly Jean Gurovitsch, LMFT
• Rebecca Guss
• Katie Marie Haferman, OTR/L

• Professional Counselor in Fridley, MN
• Providers in Fridley, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.

Verify at the official NPI Registry.