MEDICARE: GAJA COUNSELING PROFESSIONAL CORPORATION

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1285511097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAJA COUNSELING PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	400 S 4TH ST STE 410 #764480
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1419
Country	:	US
Telephone Number	:	503-734-6736
Fax Number	:

Provider Business Practice Location Address
First Line	:	3724 LYNDALE AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1127
Country	:	US
Telephone Number	:	503-734-6736
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/THERAPIST
Name	:	SAVIRA KAMBHU
Credential	:	LPCC
Telephone Number	:	503-734-6736

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	06/12/2026

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