Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Annalise Gulstad

Individual provider Mental Health Counselor · NPI 1063384295

Annalise Gulstad is a Mental Health Counselor in Minneapolis, Minnesota. Qualified in 2022, 4 years ago. Practices with Lyn-Lake Psychotherapy and Wellness Ltd, a 72-clinician group. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2025
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Practice location Address checks out

3033 Excelsior Blvd
Minneapolis, MN 55416-4688
Phone: (612) 979-2276
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence CC05199 (MN)

Record details

NPI number1063384295
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 18, 2025
Last updated in NPPESSeptember 18, 2025
Certification dateSeptember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Lyn-Lake Psychotherapy And Wellness Ltd — 72 clinicians
Accepts Medicare assignment Not indicated

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