Theresa Ketchum-Fish

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6395-125 Issued in WI

Practice address

300 Main St W
Ashland, WI 54806-1639

Phone

(715) 685-2200

NPI assigned

Sep 5, 2014

Last updated

Mar 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bad River Band of Lake Superior Tribe of Chippewa Indians WisGroup PAC ID 7810089414, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bad River Band of Lake Superior Tribe of Chippewa Indians Wis

  • Federally Qualified Health Center (FQHC)
  • Ashland, WI
  • NPI 1699701375

  TX

  Medicare reassignment Care Compare group NPD
• Bad River Band of Lake Superior Tribe of Chippewa Indains Wis

  dba Bad River AODA Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, WI
  • NPI 1366618506
  NPD
• Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.

  dba Bad River Clinic Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Ashland, WI
  • NPI 1780702829
  NPD

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1194126433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7665 US HIGHWAY 2",
            "city": "IRON RIVER",
            "state": "WI",
            "postal_code": "548474690",
            "telephone_number": "715-685-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST W",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548061639",
            "telephone_number": "715-685-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM-FISH",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6395-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Stranberg Kassof, LCSW
• Dana R Katchka, FNP-C
• Jessica Kelm
• Robin Kemkes, LPC
• Kenneth N Krutsch MDSC
• Karen Keyes, O.T.R.
• Kristi Jean Kiel, ND, PHD
• Grace M Kilbane, PHARM D
• Lisa Ogimaakwe Kingfisher, PHARMD, RPH
• Carole Kjellander, PH.D.

• Professional Counselor in Ashland, WI
• Providers in Ashland, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.