=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730365800
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHY ANNE GIESELMAN M.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2008
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5861 CEDAR LAKE RD S
-----------------------------------------------------
City | SAINT LOUIS PARK
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55416-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-202-8703
-----------------------------------------------------
Fax | 612-241-1943
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5861 CEDAR LAKE RD S
-----------------------------------------------------
City | SAINT LOUIS PARK
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55416-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 122-028-7036
-----------------------------------------------------
Fax | 612-241-1943
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 55690
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 1900
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 330
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------