Individual provider Active NPI

Marsha Wichmann, M.S.

  • Mental Health Counselor
  • Moorhead, MN
National Provider Identifier
1073901666
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
03124 Issued in MN
Practice address
725 Center Ave Ste 3
Moorhead, MN 56560-1972
Phone
(218) 366-6162
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 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 1735 ND
Addiction (Substance Use Disorder) Counselor 101YA0400X 306949 MN
Mental Health Counselor 101YM0800X 03124 MN Primary

Addresses

Primary practice location

725 Center Ave Ste 3
Moorhead, MN 56560-1972

Mailing address

725 Center Ave Ste 3
Moorhead, MN 56560-1972
Phone (182) 366-6162

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240325000965 MN Practitioner - Mental Health Counselor 0648617878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix CounselingGroup PAC ID 2264952704, 2 clinicians

Practice addresses (Care Compare)

725 Ctr Ave
Suite 3
Moorhead, MN 56560-1972
Phone (218) 366-6162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
306949MNMDAddiction (Substance Use Disorder) Counselor
1735NDMDAddiction (Substance Use Disorder) Counselor
03124MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Counseling Mental Health CurrentSince Nov 23, 2024 Accepting new patients

Locations

725 Center Ave
Ste 3
Moorhead, MN 56560
Phone (218) 366-6162

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1073901666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE STE 3",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601972",
            "telephone_number": "182-366-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE STE 3",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601972",
            "telephone_number": "218-366-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "MARSHA",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1735",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306949",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "03124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.