Active NPI
Tori Mandeville, MA, LPC
- Professional Counselor
- Stevens Point, WI
National Provider Identifier
1629434220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6580-125
- Practice address
- 106 McDill Ave Ste 300
Stevens Point, WI 54481-6212 - Phone
- (715) 354-0014
- Fax
- (715) 997-8733
- NPI assigned
- Jan 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6580-125 | WI | Primary |
Addresses
Primary practice location
106 McDill Ave Ste 300
Stevens Point, WI 54481-6212
Mailing address
106 McDill Ave Ste 300
Stevens Point, WI 54481-6212
Phone (715) 354-0014
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6580-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Wisconsin Counseling Associates, LLC | Past | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Wisconsin Rapids, WI
- NPI 1316012396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1629434220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 MCDILL AVE STE 300",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544816212",
"telephone_number": "715-354-0014",
"fax_number": "715-997-8733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 MCDILL AVE STE 300",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544816212",
"telephone_number": "715-354-0014",
"fax_number": "715-997-8733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDEVILLE",
"first_name": "TORI",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-12",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6580-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stevens Point, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.