Provider Demographics
NPI:1548790215
Name:ROBERTA GERLING LLC
Entity Type:Organization
Organization Name:ROBERTA GERLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GERLING
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:952-217-3412
Mailing Address - Street 1:16204 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3405
Mailing Address - Country:US
Mailing Address - Phone:952-217-3412
Mailing Address - Fax:952-934-3010
Practice Address - Street 1:16204 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3405
Practice Address - Country:US
Practice Address - Phone:952-217-3412
Practice Address - Fax:952-934-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5808103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty