Individual provider Active NPI

Teresa Demuro, MS LPC-IT

  • Professional Counselor
  • Menomonie, WI
National Provider Identifier
1114750874
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8178-226 Issued in WI
Practice address
800 Wilson Ave RM 330
Menomonie, WI 54751-2746
Phone
(715) 256-7166
Fax
(888) 427-8048
NPI assigned
Aug 20, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8178-226 WI Primary

Addresses

Primary practice location

800 Wilson Ave RM 330
Menomonie, WI 54751-2746

Mailing address

800 Wilson Ave RM 330
Menomonie, WI 54751-2746
Phone (715) 256-7166

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
I20260325001301 WI Practitioner - Mental Health Counselor 2769966985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Wilson Ave
RM 330
Menomonie, WI 54751-2746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8178-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Psychological and Consulting Services LLC Professional CurrentSince Aug 25, 2024 Accepting new patients

Locations

800 Wilson Ave
Rm 330
Menomonie, WI 54751
Phone (715) 256-7166

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1114750874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166",
            "fax_number": "888-427-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166",
            "fax_number": "888-427-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMURO",
        "first_name": "TERESA",
        "credential": "MS LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8178-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

Verify at the official NPI Registry.