Gregg Wahlstrom, is a
Marriage & Family Therapist based in Burnsville, Minnesota. Gregg Wahlstrom is licensed to practice in Minnesota (license number 194) and his current practice location is
14000 Fairview Dr, Burnsville, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(952) 993-8608.
NPI number for Gregg Wahlstrom is 1457339012 and his current mailing address is 6465 Wayzata Blvd, Ste 315, Minneapolis, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1457339012.
Healthcare Provider's Profile
Full Name | Gregg Wahlstrom |
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Gender | Male |
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Speciality | Marriage & Family Therapist |
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Location | 14000 Fairview Dr, Burnsville, Minnesota |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1457339012
- Provider Enumeration Date: 01/04/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Gregg Wahlstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457339012 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 2420 (Minnesota) | Primary |
106H00000X | Marriage & Family Therapist | 194 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gregg Wahlstrom is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gregg Wahlstrom, 6465 Wayzata Blvd, Ste 315, Minneapolis, MN 55426-1728 Ph: () - | Gregg Wahlstrom, 14000 Fairview Dr, Burnsville, MN 55337-5713 Ph: (952) 993-8608 |
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