Active NPI
Marcelline Anne Gangl, LPCC
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1871179465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2408
- Practice address
- 2724 University Ave SE Ste B
Minneapolis, MN 55414-3210 - Phone
- (612) 299-1090
- NPI assigned
- Mar 23, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2408 | MN | Primary |
Addresses
Primary practice location
2724 University Ave SE Ste B
Minneapolis, MN 55414-3210
Mailing address
336 E 50TH St
Minneapolis, MN 55419-1422
Phone (651) 726-4209
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2408 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1871179465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "336 E 50TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554191422",
"telephone_number": "651-726-4209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2724 UNIVERSITY AVE SE STE B",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554143210",
"telephone_number": "612-299-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGL",
"first_name": "MARCELLINE",
"middle_name": "ANNE",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-23",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "2408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.