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
Mailing address621 W Lake St Ste 350, Minneapolis, MN 55408-2952

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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