Active NPI
Erica Lynn Thibodeaux, LPC
- Mental Health Counselor
- Winona, MN
National Provider Identifier
1134611775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1924
- Practice address
- 51 E 4TH St Ste 307
Winona, MN 55987-3509 - Phone
- (507) 205-2405
- NPI assigned
- May 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1924 | MN | |
| Mental Health Counselor | 101YM0800X | 1924 | MN | Primary |
Addresses
Primary practice location
51 E 4TH St Ste 307
Winona, MN 55987-3509
Mailing address
51 E 4TH St Ste 307
Winona, MN 55987-3509
Phone (507) 205-2405
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woods Psychological Services LLC | Mental Health | Past | Accepting new patients |
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": "1527638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1134611775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 E 4TH ST STE 307",
"city": "WINONA",
"state": "MN",
"postal_code": "559873509",
"telephone_number": "507-205-2405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 E 4TH ST STE 307",
"city": "WINONA",
"state": "MN",
"postal_code": "559873509",
"telephone_number": "507-205-2405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAUX",
"first_name": "ERICA",
"middle_name": "LYNN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-30",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "1924",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "1924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.