Timothy Del Wiertzema, M.A., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2142 Issued in MN

Practice address

8669 Eagle Point Blvd
Lake Elmo, MN 55042-8628

Phone

(651) 379-0444

Fax

(651) 379-0448

NPI assigned

Oct 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Bachmann and Associates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lake Elmo, MN
  • NPI 1144210899
  NPD (past)
• Bachmann and Associates, Inc. Dba Counseling Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Elmo, MN
  • NPI 1538158506
  NPD (past)

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1164722005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8669 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-379-0444",
            "fax_number": "651-379-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8669 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-379-0444",
            "fax_number": "651-379-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERTZEMA",
        "first_name": "TIMOTHY",
        "middle_name": "DEL",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164722005",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Keltner Wessels, MSW, LICSW
• Jennifer Ann Weydert, DDS
• Susan Whalen, LICSW
• Whit Wonder Wisdom Counseling Inc
• Whit Wonder Wisdom Counseling Inc
• Amber Rene Williams
• Kari Anne Williams, MPH, MPAS, PA-C
• John Clayton Withrow, DDS
• Wendy L Worner, CRNA

• Marriage & Family Therapist in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.