Individual provider Active NPI

Andrea Wallace-Terwilliger, T-LMHC

  • Mental Health Counselor
  • Red Oak, IA
National Provider Identifier
1114607793
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1977 G Ave
Red Oak, IA 51566-4474
Phone
(712) 623-6349
Fax
(712) 623-6047
NPI assigned
Jul 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1977 G Ave
Red Oak, IA 51566-4474

Mailing address

PO Box 115
Shenandoah, IA 51601-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20251231002986 IA Practitioner - Mental Health Counselor 3274029913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

600 W Sheridan Ave
Shenandoah, IA 51601-0115

PO Box
Suite 115
Shenandoah, IA 51601-0115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Mental Health LLC Mental Health CurrentSince Dec 18, 2025 Accepting new patients

Locations

1977 G Ave
Red Oak, IA 51566
Phone (712) 623-6349

523 W Sheridan Ave
Shenandoah, IA 51601
Phone (712) 246-0159

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": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1114607793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516010115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 G AVE",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515664474",
            "telephone_number": "712-623-6349",
            "fax_number": "712-623-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE-TERWILLIGER",
        "first_name": "ANDREA",
        "credential": "T-LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Oak, IA

Sources for this page

Verify at the official NPI Registry.