Michelle Nicole Iversen, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2591 Issued in MN

Practice address

301 Main St W
New Prague, MN 56071

Phone

(507) 301-3412

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michelle Buckley Other name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Secure Base Counseling Center LLC

  • Psychologist
  • Northfield, MN
  • NPI 1285905885

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Michelle Iversen Counseling & Consulting, PLLC

  • Mental Health Counselor
  • Carver, MN
  • NPI 1659192342
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1033557152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAIN ST W",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "56071",
            "telephone_number": "507-301-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST W",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "56071",
            "telephone_number": "507-301-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSEN",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BUCKLEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Martin J Herrmann, MD
• Lois A Huber
• Laurie Ann Reiner Hughes, D.C.
• Hy-Vee Inc
• Isd 721 New Prague Area Schools
• John H Berg MD Carl E Burkland MD
• Kristal Jones, O.D.
• Tracy Kardoes
• Paul Karow, PHARM D
• Ellen Shea Kelly, PHARMD

• Marriage & Family Therapist in New Prague, MN
• Providers in New Prague, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.