Kim Marie Gleich, MA, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5146 Issued in MN

Practice address

14949 62ND St N
Stillwater, MN 55082-6132

Phone

(651) 430-6483

NPI assigned

Jun 23, 2008

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

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

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Canvas Health IncGroup PAC ID 8729073978, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1861653750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7067 LOWER 94TH ST S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163855",
            "telephone_number": "651-458-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826132",
            "telephone_number": "651-430-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEICH",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie F Gillund, SLP
• Stephanie Oreen Gilquist, LADC
• Kristi Ann Gingras, CST
• Carly Glaeser
• Mara Glantz
• Margaret Elizabeth Glennon, PA-C
• Adam D Goddard, D.O.
• Cynthia G. Goetz, PA-C
• Shannon Lynn Gonnion, P.A.
• Gossai & Knutson, DDS, PA (Southill Dental Group PA)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.