Active NPI
Michelle Rae Theesfeld, MS LMHC
- Mental Health Counselor
- Emmetsburg, IA
National Provider Identifier
1255634846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 001362
- Practice address
- 3726 450TH Ave
Emmetsburg, IA 50536-8584 - Phone
- (712) 852-3101
- Fax
- (712) 852-3100
- NPI assigned
- Dec 21, 2010
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 001362 | IA | |
| Mental Health Counselor | 101YM0800X | 001362 | IA | Primary |
Addresses
Primary practice location
3726 450TH Ave
Emmetsburg, IA 50536-8584
Mailing address
PO Box 70
Rock Valley, IA 51247-0070
Phone (712) 476-3281
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- 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, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
918 Broadway St
Suite 1
Emmetsburg, IA 50536-2489
Phone (712) 262-2922
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Spencer, IA
- NPI 1689669459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1255634846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70",
"city": "ROCK VALLEY",
"state": "IA",
"postal_code": "512470070",
"telephone_number": "712-476-3281",
"fax_number": "712-476-2970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3726 450TH AVE",
"city": "EMMETSBURG",
"state": "IA",
"postal_code": "505368584",
"telephone_number": "712-852-3101",
"fax_number": "712-852-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEESFELD",
"first_name": "MICHELLE",
"middle_name": "RAE",
"credential": "MS LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-21",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IA",
"license": "001362",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "001362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emmetsburg, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.