Provider Demographics
NPI:1679989727
Name:LANDSEE, GINA (MSED, LPCC, LADC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:LANDSEE
Suffix:
Gender:F
Credentials:MSED, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-4495
Mailing Address - Country:US
Mailing Address - Phone:651-789-7601
Mailing Address - Fax:
Practice Address - Street 1:435 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-4495
Practice Address - Country:US
Practice Address - Phone:651-789-7601
Practice Address - Fax:651-225-0882
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2841101YM0800X
MN306672101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health