Kathleen Paige Gullo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

12805 Highway 55
Suite 211
Plymouth, MN 55441-3859

Phone

(763) 550-9005

Fax

(763) 559-2118

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By 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

Mental Health Counselor

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Central Ministry Development Center, Inc.Group PAC ID 7214346345, 7 clinicians

Practice addresses (Care Compare)

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

• North Central Ministry Development Center, Inc.

  dba LeaderWise Counseling

  • Counseling Psychologist
  • New Brighton, MN
  • NPI 1164711735
  Medicare reassignment Care Compare group NPD
• Minnesota Psychological Resources

  • Clinical Social Worker
  • Plymouth, MN
  • NPI 1497820039

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982776555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 55",
            "address_2": "SUITE 211",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413859",
            "telephone_number": "763-550-9005",
            "fax_number": "763-559-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 55",
            "address_2": "SUITE 211",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413859",
            "telephone_number": "763-550-9005",
            "fax_number": "763-559-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLO",
        "first_name": "KATHLEEN",
        "middle_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Grumbir, RD, LD
• Afya Gubara
• Roman Gabriel Guerrero-Maestre, M.D.
• Guiding Star Psychological Services LLC
• Donna Renee Guimond, OTR/L
• Rishi Kumar Gupta, M.D.
• Ashley Gust, RN
• Pamela J Gustafson
• Tamera Lynn Haase, PHARMD
• Dean Hadland

• Mental Health Counselor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.