Sheritta R Phillips, MS, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC03803 Issued in MN

Practice address

1875 Northwestern Ave S
Stillwater, MN 55082-7534

Phone

(651) 789-4039

Fax

(651) 439-4894

NPI assigned

Jun 6, 2023

Last updated

Jun 6, 2023By the provider in NPPES

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

• Sheritta Gales Former 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

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Familymeans

  • Mental Health Counselor
  • Stillwater, MN
  • NPI 1881690899
  Medicare reassignment NPD

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1053005843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-789-4039",
            "fax_number": "651-439-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-789-4039",
            "fax_number": "651-439-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHERITTA",
        "middle_name": "R",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERITTA",
            "last_name": "GALES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Petrosky, PA-C
• Heather Christine Pett Taylor, M.D.
• Virginia K Peulen, PT
• Anika Schulte Phillips, RN, CNM
• Laura Marie Phillips, M.A., LMFT
• Kathleen Marie Picard, PT
• Kristi Pikala, LPCC
• Elizabeth Pilney
• Nicholas Pilney, LPCC
• James Piper, LADC

• Mental Health Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.