Active NPI
Abigail Hadassah Gewirtz, PHD, LP
- Psychologist
- St Paul, MN
National Provider Identifier
1750368353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP4278
- Practice address
- 2550 University Ave West
Ste 229N
St Paul, MN 55114 - Phone
- (651) 645-3115
- Fax
- (651) 645-2752
- NPI assigned
- Dec 27, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 | LP4278 | MN | Primary |
Addresses
Primary practice location
2550 University Ave West
Ste 229N
St Paul, MN 55114
Mailing address
1088 Overlook Rd
Mendota Heights, MN 55118
Phone (651) 365-1249
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 137T0GE | Other | MN | BCBS OF MN |
| 438230700 | Medicaid | MN | |
| 6133092 | Other | MN | MEDICA |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4278 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Recovery Inc | Psychologist | Past | Accepting new patients |
| Psychiatric Recovery PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Saint Paul, MN
- NPI 1891713681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250121600000",
"number": "1750368353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1088 OVERLOOK RD",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "55118",
"telephone_number": "651-365-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE WEST",
"address_2": "STE 229N",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55114",
"telephone_number": "651-645-3115",
"fax_number": "651-645-2752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWIRTZ",
"first_name": "ABIGAIL",
"middle_name": "HADASSAH",
"credential": "PHD, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-27",
"last_updated": "2009-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP4278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "137T0GE",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "438230700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6133092",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.