Deborah Ellen Neitzke, MS, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

00164 Issued in MN

Practice address

1406 6TH Avenue North
St. Cloud Hospital
St. Cloud, MN 56303-1901

Phone

(320) 251-2700

Fax

(320) 229-5109

NPI assigned

Mar 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Deborah Ellen Weappa Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment NPD
• St. Cloud Hospital

  • Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1619934627
  NPD (past)

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1194049023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR # 2475",
            "address_2": "CENTRA CARE HEALTH PLAZA",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-5199",
            "fax_number": "320-229-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST. CLOUD HOSPITAL",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-229-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITZKE",
        "first_name": "DEBORAH",
        "middle_name": "ELLEN",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "00164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "WEAPPA",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Navarro
• NBH St Cloud LLC
• Virginia Lynnea Neal, LICSW
• Patricia A Nee, MD
• Jessica Rose Neeser, OTR/L
• Frank P Nellans, M.D.
• Tracy J Nellans, RN, CRNA
• Ashton Nelsen, DPM
• Angela Joy Nelson, PHARM.D., R.PH.
• Daniel Joseph Nelson, RPH

• Professional Counselor in St. Cloud, MN
• Providers in St. Cloud, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.