Veronica M Ellingworth, MS, LPC, SAC, ICS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6410-125 Issued in WI

Practice address

100 Business Park Cir Ste 202
Stoughton, WI 53589-5501

Phone

(608) 695-0960

NPI assigned

Sep 26, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Velvaere Mental Health Clinic, LLCGroup PAC ID 1456893403, 3 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 and National Provider Directory roles.

• Velvaere Mental Health Clinic, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stoughton, WI
  • NPI 1770346702

  Counselor

  Medicare reassignment Care Compare group NPD Authorized official
• Oceanhawk Counseling Alternatives LLC

  • Addiction (Substance Use Disorder) Counselor
  • Stoughton, WI
  • NPI 1245341205
  NPD (past)

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1528577152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E HUBERT ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341318",
            "telephone_number": "608-695-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BUSINESS PARK CIR STE 202",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535895501",
            "telephone_number": "608-695-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGWORTH",
        "first_name": "VERONICA",
        "middle_name": "M",
        "credential": "MS, LPC, SAC, ICS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "6410-125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16161-131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6410-125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6410-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Druckenbrod, LCSW
• Jeanne Marie Duncan, PT
• Denise Marie Duranczyk, MS, PT
• Eds
• Cindy Lee Ehr, COTA
• Comfort C Eruchalu, RN
• Daniel R Eugster, D.C.
• Tara N. Evans, P.T.
• Everside Health-Sti Stoughton
• Stacey Farley

• Mental Health Counselor in Stoughton, WI
• Providers in Stoughton, 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 2, 2024; 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.