NICHOLAS GAMMELLO (NPI# 1558383000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558383000 |
| Entity Type | Individual |
| Full Name | NICHOLAS GAMMELLO |
| Practice Address |
7251 Excelsior Rd Baxter MN 56425 |
| Mailing Address |
Po Box 2506 Baxter MN 56425-2506 |
| Practice Telephone | 2184540878 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2019-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1437 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS | 62Q99GA | 01 |
| MN | 731353500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14275 Golf Course Dr., 160, Baxter, MN 56425 | 2188281028 | 2188240137 |
| Street Address |
7251 EXCELSIOR RD |
| City | BAXTER |
| State | MN |
| Zip Code | 56425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609355171 | Samantha Cole | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2018-08-07 |
| 1598271926 | Jennifer Lee Perez Krueger | Social Worker | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2017-12-21 |
| 1912454257 | Luke Hamilton | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2016-09-03 |
| 1326405788 | Tracey Marie Malone | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425 | 2016-01-15 |
| 1316303928 | Timothy James Anderson | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425 | 2016-01-12 |
| 1275907362 | Lakes Country Counseling | Community/Behavioral Health | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2015-11-30 |
| 1366823999 | Terry Stumbo | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2015-06-09 |
| 1508247149 | Donette Lair | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2015-06-09 |
| 1194105205 | Jamie Teresa Whiteman | Social Worker | 7251 Excelsior Rd, Baxter, MN 56425-8477 | 2015-06-03 |
| 1639565732 | Kelly Brinkman | Marriage & Family Therapist | 7251 Excelsior Rd, Baxter, MN 56425 | 2015-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396364089 | Jennifer Ann Olson | Behavioral Analyst | Autism Matters 14387 Edgewood Drive, Baxter, MN 56425 | 2020-04-13 |
| 1801229000 | Longville Lakes Clinic, Inc. | Clinic/Center | 13205 Isle Drive, Baxter, MN 56425 | 2013-08-12 |
| 1033555867 | Shiela Klemmetsen | Family Medicine | Essentia Health St. Joseph's-baxter Clinic, 13060 Isle Drive, Baxter, MN 56425 | 2013-05-20 |
| 1053547299 | Linda Marie Bowman | Social Worker | 13397 Shadow Wood Drive, Baxter, MN 56425 | 2009-06-02 |
| 1215112792 | Brainerd Medical Center, Inc. | Nurse Practitioner | 14133 Edgewood Drive, Baxter, MN 56425 | 2008-01-03 |
| 1134313208 | Sleep Center of Central Minnesota LLC | Clinic/Center | 13495 Elder Drive, Suite 120, Baxter, MN 56425 | 2007-08-31 |
| 1750582482 | Jacqueline Elizabeth Oelfke | Nurse Practitioner | Cbhh-baxter, 14241 Grand Oaks Dr., Baxter, MN 56425 | 2007-05-30 |
| 1508080631 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14398 Grand Oaks Drive, Baxter, MN 56425 | 2007-04-12 |
| 1093842247 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14396 Grand Oaks Dr, Baxter, MN 56425 | 2007-02-27 |
| 1053458364 | Teri Kaminski Peterson | Speech-Language Pathologist | 15620 Edgewood Dr Ste 240, Baxter, MN 56425 | 2007-01-30 |
| Find all providers in zip 56425 | ||||
| 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 |
|---|---|---|---|---|
| 1992110910 | Birchwood Therapy Services, Plc | Psychologist | 13968 Cypress Dr Ste 1a, Baxter, MN 56425-5904 | 2014-06-27 |
| 1437163417 | Bryn Yahn | Psychologist | 14275 Golf Course Dr., Suite 160, Baxter, MN 56425 | 2006-07-28 |
| 1104872423 | Amanda Jo Hintz | Psychologist | 7115 Forthun Rd, Suite 105, Baxter, MN 56425-8597 | 2006-05-26 |
| 1871596585 | Gerald E. Jensen, Jr. | Psychologist | 6980 Fairview Rd, Suite 110, Baxter, MN 56425-7836 | 2005-05-27 |
| 1487956033 | Larry Howard Zarling | Psychologist | 7115 Forthun Road, Suite 105, Baxter, MN 56425 | 2010-12-01 |
| 1770748410 | Jill Janel Sovine Dahmen | Psychologist | 7251 Excelsior Rd, Baxter, MN 56425 | 2008-07-22 |
| 1760544423 | Jeanne Marie Kurtz | Psychologist | 7115 Forthun Road, Suite 105, Baxter, MN 56425 | 2006-12-15 |
| 1134148885 | Diane Dunn | Psychologist | 13021 Evergreen Dr, Baxter, MN 56425-7439 | 2006-07-19 |
| 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 | ||||
Please comment or provide details below to improve the information on NICHOLAS GAMMELLO.
| 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.