Individual provider Active NPI

Ruchita Ervin

  • Professional Counselor
  • Monona, WI
National Provider Identifier
1063891992
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6487-125 Issued in WI
Practice address
1955 W Broadway Ste 104
Monona, WI 53713-3700
Phone
(608) 405-3002
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17263-130 WI
Marriage & Family Therapist 106H00000X 440-228 WI
Professional Counselor 101YP2500X 6487-125 WI Primary

Addresses

Primary practice location

1955 W Broadway Ste 104
Monona, WI 53713-3700

Mailing address

1955 W Broadway Ste 104
Monona, WI 53713-3700
Phone (608) 405-3002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20250522000849 WI Practitioner - Mental Health Counselor 0547789612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Generations IncGroup PAC ID 5294254363, 2 clinicians

Practice addresses (Care Compare)

1955 W Broadway
Suite 104
Monona, WI 53713-3700
Phone (608) 405-3002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17263-130WIMDAddiction (Substance Use Disorder) Counselor
440-228WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Generations Inc. Professional CurrentSince Jan 1, 2023 Accepting new patients
Quality Addiction Management Inc Addiction (Substance Use Disorder) Past Accepting new patients
Quality Addiction Management Inc Past Accepting new patients

Locations

1955 W Broadway
Ste 104
Monona, WI 53713
Phone (608) 217-2650

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1063891992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 W BROADWAY STE 104",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133700",
            "telephone_number": "608-405-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W BROADWAY STE 104",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133700",
            "telephone_number": "608-405-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "RUCHITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17263-130",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "440-228",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6487-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.