Theressa Watt, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3553 Issued in MN

Practice address

1154 Grand Ave Ste 2
Saint Paul, MN 55105-2628

Phone

(612) 567-4842

NPI assigned

Jun 12, 2019

Last updated

Jun 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Theressa Durenberger Professional name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Invigorate Life Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1508107541
  Medicare reassignment NPD

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1689233538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 GRAND AVE STE 2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 GRAND AVE STE 2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052628",
            "telephone_number": "612-567-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "THERESSA",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESSA",
            "last_name": "DURENBERGER",
            "credential": "MA, LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nancy B Watkins, NNP
• Samantha Watkins
• Tina Watson Wiens, MA, LMFT
• Emma Grace Watson, PT, DPT
• Mark Douglas Watson, D.D.S.
• Nicole Wavra
• George Wawro, LADC, MSW, LICSW
• Way-Maker Solutions LLC
• June N Way
• Christa Lane Waymire, M.D.

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.