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General NPI Number Information
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NPI Number | 1295131779
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Entity Type | Organization
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Legal Business Name | VANDA COUNSELING AND PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 11/11/2014
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 4969 OLSON MEMORIAL HWY
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City | GOLDEN VALLEY
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State | MN
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Zip | 55422-5138
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Country | US
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Telephone | 763-575-8086
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Fax | 320-774-0415
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Provider Business Mailing Address
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Address Line | 14000 NORTHDALE BLVD STE I
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City | ROGERS
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State | MN
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Zip | 55374-4663
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Country | US
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Telephone | 763-575-8086
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Fax | 320-774-0415
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA E GERBIG
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Credential | LICSW
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Telephone | 763-464-9256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4781
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License Number State | MN
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