FIRESIDE COUNSELING LLC (NPI# 1447524285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447524285 |
| Entity Type | Organization |
| Organization Name | FIRESIDE COUNSELING LLC |
| Practice Address |
9350 Oak Ave Waconia MN 55387-5500 |
| Mailing Address |
9350 Oak Ave Po Box 42 Waconia MN 55387-5500 |
| Practice Telephone | 9524420040 |
| Mailing Telephone | 9522702086 |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-05-12 |
| Authorized Official Name | DR. GARY JOSEPH FREITAS (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 9524420040 |
| Authorized Official Credential | PH.D., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP 4675 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | 680002139 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508258732 | Fireside Counseling LLC | Counselor | 101 1/2 E Front St, Suite 106, Wheaton, IL 60187-5334 | 2015-02-25 |
| 1629580139 | Fireside Counseling LLC | Social Worker | 5821 Staples Mill Rd, Richmond, VA 23228-5427 | 2017-10-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Fireside Counseling LLC | 5821 Staples Mill Rd, Richmond, Virginia 23228 |
| Street Address |
9350 OAK AVE |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689666349 | Andrea L Benjamin Malp Ltd | Psychologist | 137 W 1st St, Waconia, MN 55387-1190 | 2005-08-18 |
| 1700887379 | Anna Skytta-gurkanlar | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-09 |
| 1083846885 | Michelle L Purtle | Psychologist | 540 E 1st St, Waconia, MN 55387-1600 | 2009-08-13 |
| 1225030778 | David Steven Homorody | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-15 |
| 1376545806 | James Robert Rudolph | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-15 |
| 1962404426 | Michael James Tanguay | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-15 |
| 1194727552 | Michael Allen Scott | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-15 |
| 1346241551 | Gary Edward Donaldson | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-10 |
| 1679574990 | Jeanette Leone Mitchell | Psychologist | 540 E 1st St, Waconia, MN 55387-1601 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493952 | Michelle Brownfield | Psychologist | 606 Spear Ave, Duluth, MN 55803-2154 | 2020-10-01 |
| 1730716994 | Tamolyn Patterson Benke | Psychologist | 8453 Casey Ct, Inver Grove Heights, MN 55076-5154 | 2020-03-26 |
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1134764871 | Avital Ogniewicz | Psychologist | 2519 Commerce Dr Nw, Rochester, MN 55901-4432 | 2019-11-15 |
| 1164065868 | Karen Nicole Chinnock | Psychologist | 930 Blue Gentian Rd, Eagan, MN 55121-1674 | 2019-10-25 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1083257349 | Nathaniel Page | Psychologist | 2423 Valley Dr, Northfield, MN 55057-3224 | 2019-10-18 |
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1881243590 | Bill Clafton Psyd Lp LLC | Psychologist | 1755 Old West Main St Ste 204, Red Wing, MN 55066-3057 | 2019-09-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.