Karen Leta Gillespie

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3772 Issued in MN

Practice address

7954 University Ave NE
Fridley, MN 55432-1860

Phone

(763) 780-3036

NPI assigned

Nov 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Indian Health Board of Minneapolis, Inc

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1811999162

  MN

  Medicare reassignment NPD
• Indian Health Board of Minneapolis

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1578670188
  NPD
• Indian Health Board of Minneapolis, Inc

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1760949168
  NPD
• Lee Carlson Center for Mental Health and Well-Being

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

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1730725482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 18 1/2 AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554184522",
            "telephone_number": "612-220-4610"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "KAREN",
        "middle_name": "LETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": "18-345",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farhiya Mahamud Gelle I
• Dereje M Gemeda
• Sarah Elaine Gibson
• Tricia K. Gibson, M.A., LMFT
• Nathan Paul Gille, OPA-C
• Robert Blackford Gillum III, DDS
• Ellen Catherine Gish, MA, LPCC
• Global Case Management
• Jesse L Goembel, PA-C
• Joann Carol Goiffon, M.S., CCC-SLP

• All providers in Fridley, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.