Individual provider Active NPI

Ashley Todd

  • Professional Counselor
  • Mora, MN
National Provider Identifier
1407586217
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3619 Issued in MN
Practice address
2031 Rowland Rd
Mora, MN 55051-7119
Phone
(320) 364-1300
Fax
(651) 323-2558
NPI assigned
Jun 14, 2022
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 304972 MN
Professional Counselor 101YP2500X 3619 MN Primary

Addresses

Primary practice location

2031 Rowland Rd
Mora, MN 55051-7119

Mailing address

2031 Rowland Rd
Mora, MN 55051-7119
Phone (320) 364-1300

Other practice location 1

28 Union St N
Mora, MN 55051-1355
Phone (320) 703-8151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
304972MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wikelius Counseling & Supervision, Inc. PastSince Apr 17, 2022 Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1407586217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 ROWLAND RD",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550517119",
            "telephone_number": "320-364-1300",
            "fax_number": "651-323-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 ROWLAND RD",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550517119",
            "telephone_number": "320-364-1300",
            "fax_number": "651-323-2558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Union St N",
            "address_purpose": "LOCATION",
            "city": "Mora",
            "state": "MN",
            "postal_code": "550511355",
            "country_code": "US",
            "telephone_number": "320-703-8151",
            "fax_number": "320-210-1830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "304972",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mora, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.