Bonnie Rose Theis, MS, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2630 Issued in MN

Practice address

24 3Rd Ave NE
Unit B
Osseo, MN 55369

Phone

(651) 560-0050

Fax

(651) 925-0257

NPI assigned

Nov 6, 2020

Last updated

Nov 6, 2020By 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

Electronic endpoints 1

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoy and Associates Inc.Group PAC ID 6608318498, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Hoy & Associates Inc.

  dba David Hoy & Associates Ltd

  • Community/Behavioral Health Agency
  • Golden Valley, MN
  • NPI 1831239003
  Medicare reassignment Care Compare group NPD
• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  NPD (past)
• Threads of Hope Counseling, LLC

  • Marriage & Family Therapist
  • Eagan, MN
  • NPI 1194190728

  Professional

  NPD (past)

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1376144188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 21ST ST STE 232",
            "city": "NEWPORT",
            "state": "MN",
            "postal_code": "550551182",
            "telephone_number": "651-560-0050",
            "fax_number": "651-925-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 3RD AVE NE",
            "address_2": "UNIT B",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "651-560-0050",
            "fax_number": "651-925-0257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Park Glen Rd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554165427",
            "country_code": "US",
            "telephone_number": "612-925-6033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEIS",
        "first_name": "BONNIE",
        "middle_name": "ROSE",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://www.therapyportal.com/p/threads/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24 3rd Ave NE",
            "address_2": "Unit B",
            "city": "Osseo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.