Provider Demographics
NPI:1629246236
Name:GELEP, ROBERT GREGORY (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GREGORY
Last Name:GELEP
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4858 BANNING AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-2870
Mailing Address - Country:US
Mailing Address - Phone:651-402-8883
Mailing Address - Fax:651-653-7033
Practice Address - Street 1:1485 81ST AVE NE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-2111
Practice Address - Country:US
Practice Address - Phone:763-780-0784
Practice Address - Fax:763-780-0784
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-16
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1633106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist