Terri O'Donnell LPC Sasa LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4013-125 Issued in WI

Legal business name

TERRI O'DONNELL LPC SASA LLC

Practice address

802 W Broadway
Suite 206
Monona, WI 53713-1821

Phone

(608) 347-5015

NPI assigned

Apr 3, 2011

Last updated

Apr 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa Anne O'Donnell, LPC, SASANPI 1104158575

Title

Owner

Phone

(608) 347-5015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Teresa Anne O'Donnell, LPC

  • Mental Health Counselor
  • Madison, WI
  • NPI 1104158575
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1301788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301788800000",
    "number": "1356630040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NASHUA LN",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279551",
            "telephone_number": "608-347-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W BROADWAY",
            "address_2": "SUITE 206",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131821",
            "telephone_number": "608-347-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRI O'DONNELL LPC SASA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-03",
        "last_updated": "2011-04-03",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-347-5015",
        "authorized_official_credential": "LPC, SASA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4013-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Monona, WI
• Providers in Monona, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.