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NPI Code Detail

MEDICARE: VANDA COUNSELING AND PSYCHOLOGICAL SERVICES

MEDICARE: VANDA COUNSELING AND PSYCHOLOGICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency4781MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295131779
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANDA COUNSELING AND PSYCHOLOGICAL SERVICES
Provider Business Mailing Address
First Line : 14000 NORTHDALE BLVD STE I
Second Line :
City : ROGERS
State : MN
Zip : 55374-4663
Country : US
Telephone Number : 763-575-8086
Fax Number : 320-774-0415
Provider Business Practice Location Address
First Line : 4969 OLSON MEMORIAL HWY
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-5138
Country : US
Telephone Number : 763-575-8086
Fax Number : 320-774-0415
Authorized Official
Title or Position : OWNER
Name : REBECCA E GERBIG
Credential : LICSW
Telephone Number : 763-464-9256
Provider Enumeration Date : 11/11/2014
Last Update Date : 02/11/2026

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Directions to “VANDA COUNSELING AND PSYCHOLOGICAL SERVICES ” Practice Location

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