Tayler Waldvogel, M.S. LADC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

105 2ND Ave NE Ste 110
Glenwood, MN 56334-1226

Phone

(320) 428-0744

Fax

(320) 438-2829

NPI assigned

May 29, 2019

Last updated

Jul 25, 2022By 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 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Country Counseling PCGroup PAC ID 7517409691, 2 clinicians

Practice addresses (Care Compare)

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

• North Country Counseling P.C.

  dba North Country Counseling

  • Community/Behavioral Health Agency
  • Glenwood, MN
  • NPI 1982115390
  Medicare reassignment Care Compare group NPD
• Thrive Behavioral Network IV, LLC

  dba New Visions Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Alexandria, MN
  • NPI 1740359199
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1326605015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 2ND AVE NE STE 110",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341226",
            "telephone_number": "320-428-0744",
            "fax_number": "320-438-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 2ND AVE NE STE 110",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341226",
            "telephone_number": "320-428-0744",
            "fax_number": "320-438-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDVOGEL",
        "first_name": "TAYLER",
        "credential": "M.S. LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2022-07-25",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305440",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Mae Vanderhagen, FNP-C
• Vandesteeg & Larson Optometric Clinic PA (Glacial Ridge Eye Clinic)
• Vandesteeg & Larson Optometric Clinic, PA (Glacial Ridge Eye Clinic)
• Amanda Volesky, PT, DPT
• Nikki Wait
• Carl Stephen Wallin, D.D.S.
• Western Prairie Human Services
• Luke Thomas Wilmes, RN
• Jessica Lynn Wilson, CNP
• Kemma Wing, LPCC

• Professional Counselor in Glenwood, MN
• Providers in Glenwood, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.