Active NPI
Maria McDermit
- Professional Counselor
- West Bend, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 16649
- Practice address
- 1626 Clarence CT
West Bend, WI 53095-8533 - Phone
- (262) 338-8611
- NPI assigned
- Dec 5, 2013
- Last updated
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1967-226 | WI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16649-130 | WI | |
| Professional Counselor | 101YP2500X | 16649 | WI | Primary |
Addresses
Primary practice location
1626 Clarence CT
West Bend, WI 53095-8533
Mailing address
1626 Clarence CT
West Bend, WI 53095-8533
Phone (262) 338-8611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100049654 | Medicaid | WI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
116 N Dodge St
Suite 5
Burlington, WI 53105-1963
Phone (262) 767-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1967-226 | WI | MD | Counselor |
| 16649-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 16649 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
116 N Dodge St
Ste 5
Burlington, WI 53105
Phone (262) 727-4300
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Organizations & group practices 2
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.
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- Oshkosh, WI
- NPI 1326858044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1205267994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 CLARENCE CT",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530958533",
"telephone_number": "262-338-8611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1626 CLARENCE CT",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530958533",
"telephone_number": "262-338-8611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMIT",
"first_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-05",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "1967-226",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "16649-130",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "16649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100049654",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.