Gwen Katrina Pedersen, M.S.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1156 Issued in MN

Practice address

600 25TH Ave S Ste 109
Saint Cloud, MN 56301-4820

Phone

(320) 255-0343

Fax

(320) 654-0318

NPI assigned

Sep 21, 2006

Last updated

Feb 20, 2024By the provider in NPPES

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

Marriage and Family Therapist

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Master of Science - Law

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gwen Pedersen LLC

  • Marriage & Family Therapist
  • Saint Cloud, MN
  • NPI 1750090858
  Medicare reassignment NPD Authorized official
• Center for Family Counseling Inc

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1588731327
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1902905516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 STEARNS WAY STE 111",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S STE 109",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014820",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "GWEN",
        "middle_name": "KATRINA",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Pebworth, LPN
• Sandy Lynn Peck, AU.D.
• Sue Peck, PT
• Matthew Albert Peckskamp, PA-C
• Cassandra Elizabeth Pedersen, RD
• Erin Marie Pederson, PA-C
• Ginger Lyn Pederson, LICSW
• Jeremy Pederson, BSN, PHN
• Megan Ryleigh Pederson
• Marilyn J Peitso, MD

• Marriage & Family Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.