Michelle Lynn Manthei
Individual provider Active NPI Professional Counselor · Morris, MN
NPI 1609650175 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1609650175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC03970 (MN)
- Practice address
- 400 E 1St St
Morris, MN 56267-1408 - Phone
- (320) 589-7625
- Fax
- (320) 589-7686
- NPI assigned
- Aug 24, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240119002496 | MN | Practitioner - Mental Health Counselor | 8729430285 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3970 | MN | MD | Mental Health Counselor |
| CC03970 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stevens Community Medical Center Inc | Current |
Accepting new patients | |
| Stevens Community Medical Center Inc | Current |
Accepting new patients | |
| Stevens Community Medical Center Inc. | Current | Accepting new patients |
Locations
400 E 1st St
Morris, MN 56267
Phone (320) 589-1313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC03970 | MN | Yes |
Addresses
Primary practice location
400 E 1St St
Morris, MN 56267-1408
Mailing address
400 E 1St St
Morris, MN 56267-1408
Phone (320) 589-7625
Other practice location 1
56278 220th St
Alberta, MN 56207-4660
Phone (320) 287-0739
Other names
- Michelle Lynn Wagner
Other providers in Morris, MN
- Steven Edward Lienemann
- Rondi Lillehaug
- LP Companies of Morris, Inc.
- Randell Craig Lussenden
- Nathan Bryant Malek
- Chelsea McKinney
- Elizabeth Meichsner
- Connor Metzger
- June Meyerhoff
- Midwest Special Education Cooperative #5-398
All providers in Morris, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.