Theodore Robert Hidding, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1742 Issued in MN

Practice address

13968 Cypress Dr Ste 1a
Baxter, MN 56425

Phone

(218) 454-1082

NPI assigned

Feb 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Birchwood Therapy Services, PLC

  • Psychologist
  • Baxter, MN
  • NPI 1992110910
  NPD (past)

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1437658606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13968 CYPRESS DR STE 1A",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564255904",
            "telephone_number": "218-454-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13968 CYPRESS DR STE 1A",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "56425",
            "telephone_number": "218-454-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18532 Hartley Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "564016899",
            "country_code": "US",
            "telephone_number": "952-334-5701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIDDING",
        "first_name": "THEODORE",
        "middle_name": "ROBERT",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndsey H Herman, OTR/L
• Elizabeth Kae Hermanson, DPT
• Mariah Herold, DDS
• Tracy Hershey
• Karena Hertling
• Alexis P Hillmer, PA-C
• Nicole Lynn Hines
• Amanda Jo Hintz, MS, LP
• Morgan Hirchert
• Nancy Jean Hirschenberger, LICSW

• Mental Health Counselor in Baxter, MN
• Providers in Baxter, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.