Ingvild Mikkelborg, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3090 E Coronado TRL # Az86335
Rimrock, AZ 86335-5283

Phone

(928) 567-1322

NPI assigned

Jul 11, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1558095067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W STATE ROUTE 89A # 1157",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863366135",
            "telephone_number": "928-567-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 E CORONADO TRL # AZ86335",
            "city": "RIMROCK",
            "state": "AZ",
            "postal_code": "863355283",
            "telephone_number": "928-567-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELBORG",
        "first_name": "INGVILD",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Cy Garden, LPC
• Mark Gonchar, LASAC
• Clay Conrad Khin
• Lake Montezuma RTC, LLC
• Katie McAndrew, SLPA
• Montezuma Rimrock Fire District
• Timothy Mullins, MA
• Shelbi Lynn Labat Petrosius, LPC
• Nancy Ann Pfefferkorn, OTR/L
• Rapha Wellness LLC

• All providers in Rimrock, AZ
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.