Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Heather Gallivan

Individual provider Psychologist · NPI 1477538247

Heather Gallivan is a Clinical Psychologist in Minneapolis, Minnesota. Qualified in 2002, 24 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
24
Licensed in
MN
In the registry since
2005
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Practice location Address checks out

6490 Excelsior Blvd Ste W505
Minneapolis, MN 55426-4705
Phone: (952) 993-6200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP4521 (MN)

Record details

NPI number1477538247
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 14, 2005
Last updated in NPPESJuly 13, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Park Nicollet Clinic

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1773 clinicians in the practice; 12 are shown here.

Other providers in Minneapolis