Individual provider Active NPI

Monica A Birsen, LPCC-S

  • Counselor
  • Maumee, OH
National Provider Identifier
1053502674
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E0004169 Issued in OH
Practice address
1446 Reynolds Rd Ste 301
Maumee, OH 43537-1634
Phone
(419) 340-7706
Fax
(419) 932-6657
NPI assigned
Aug 8, 2007
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E0004169 OH Primary

Addresses

Primary practice location

1446 Reynolds Rd Ste 301
Maumee, OH 43537-1634

Mailing address

1446 Reynolds Rd Ste 301
Maumee, OH 43537-1634
Phone (419) 340-7706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E0004169OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Wellness & Healing LLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

1446 Reynolds Rd
Ste 301
Maumee, OH 43537
Phone (419) 304-3798

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1053502674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 REYNOLDS RD STE 301",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-340-7706",
            "fax_number": "419-932-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 REYNOLDS RD STE 301",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-340-7706",
            "fax_number": "419-932-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRSEN",
        "first_name": "MONICA",
        "middle_name": "A",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E0004169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.