Thea L Rothmann, PH.D.
Individual provider Active NPI Clinical Psychologist · Fergus Falls, MN
NPI 1679769236 · NPPES record last updated Jun 16, 2023
Key facts
- NPI
- 1679769236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 4848 (MN)
- Practice address
- 116 E Lincoln Ave
Fergus Falls, MN 56537-2217 - Phone
- (218) 382-5380
- NPI assigned
- Sep 18, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Strong Self Mental Health PLLP
Alluma Inc
Practice addresses (Care Compare)
116 E Lincoln Ave
Fergus Falls, MN 56537-2217
Phone (218) 382-5380
603 Bruce St
Crookston, MN 56716-2914
Phone (218) 281-3940
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 |
|---|---|---|---|---|
| I20080324000406 | MN | Practitioner - Clinical Psychologist | 1254417850 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4848 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alluma, Inc. | Current |
Accepting new patients | |
| Strong Self Mental Health, PLLP | Clinical | Current |
Accepting new patients |
Locations
603 Bruce St
Crookston, MN 56716
Phone (218) 281-3940
1422 Central Ave NE
East Grand Forks, MN 56721
Phone (218) 773-6102
116 E Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 205-1079
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4848 | MN | Yes |
Addresses
Primary practice location
116 E Lincoln Ave
Fergus Falls, MN 56537-2217
Mailing address
25489 344TH Ave
Battle Lake, MN 56515-9633
Phone (218) 280-6167
Other providers in Fergus Falls, MN
- Jamie Marie Rodriguez
- Rolandson Hearing Aid Center
- April Ann Romfo
- Anthony Rooney
- Christiana Rotering
- Christopher John Rott
- Craig R Rude
- Jessica Marie Rudy
- Kristi Rufer
- Jane Ellen Rumohr
All providers in Fergus Falls, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2023. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.