Irene Churchill, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC03518 Issued in MN

Practice address

579 Wells St
Saint Paul, MN 55130-4134

Phone

(651) 793-3803

NPI assigned

Sep 23, 2022

Last updated

Sep 23, 2022By the provider in NPPES

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

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

Practice roles

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.

• Namu Integrative Therapy Services, LLC

  • Clinical Psychologist
  • Saint Paul, MN
  • NPI 1275175242
  Medicare reassignment NPD

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1699498758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 ALDRICH AVE S APT 6",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 WELLS ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304134",
            "telephone_number": "651-793-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "IRENE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC03518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianito Sia Chua, MD
• Ashley Suhyun Chung
• Kerri Wing-Hun Chung, D.O.
• Won G Chung, MD
• Ryan Ernest Chupp, M.D.
• Adolfo Chuy, MD
• CHW Solutions LLC
• CHW Solutions LLC
• Anne Ciaschini Marmol, PHARMD, MPH
• Jane Cicchese, RN, LSN, PHN

• Professional Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.