Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HEATHER GALLIVAN
NPI 1477538247
Psychologist in Minneapolis, MN

Active since December 14, 2005PECOS Enrolled
6490 EXCELSIOR BLVD, SUITE W505, MINNEAPOLIS, MN 55426(952) 993-6200 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Heather Gallivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHER GALLIVAN (NPI 1477538247) is an individual psychologist in Minneapolis, Minnesota, licensed in Minnesota (LP4521) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1477538247
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameHEATHER GALLIVAN
Location Address6490 EXCELSIOR BLVD, SUITE W505Minneapolis, MN 55426-4705
Mailing Address6465 Wayzata Blvd, Suite 315St Louis Park, MN 55426-1728
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateDecember 14, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1477538247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP4521
Definition
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.
6490 EXCELSIOR BLVD, Minneapolis, MN 55426

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Heather Gallivan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365417557
PECOS Enrollment IDI20040831001133
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Pulmonary Disease)
6490 EXCELSIOR BLVD, SUITE W300
ST LOUIS PARK, MN 55426
Physician Assistant
6490 EXCELSIOR BLVD, STE E400
ST LOUIS PARK, MN 55426
Physician Assistant
6490 EXCELSIOR BLVD, STE W200
ST LOUIS PARK, MN 55426
Specialist/Technologist, Other (Surgical Technologist)
6490 EXCELSIOR BLVD, SUITE E400
ST LOUIS PARK, MN 55426
Psychiatry & Neurology (Neurology)
6490 EXCELSIOR BLVD, STE E500
ST LOUIS PARK, MN 55426
Pharmacist
6490 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Psychologist
6490 EXCELSIOR BLVD, # E315
ST LOUIS PARK, MN 55426
Occupational Therapist
6490 EXCELSIOR BLVD, SUITE E400 REHAB SERVICES
ST LOUIS PARK, MN 55426

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heather Gallivan's NPI number?

The NPI number for Heather Gallivan is 1477538247. It was assigned to this individual provider in the NPPES registry on December 14, 2005.

Where is Heather Gallivan located?

Heather Gallivan practices at 6490 Excelsior Blvd Suite W505, Minneapolis, MN 55426. The listed phone number is (952) 993-6200.

What is Heather Gallivan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Heather Gallivan enrolled in Medicare?

Yes. Heather Gallivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Heather Gallivan was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.