Shari Phillips, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01963 Issued in MN

Practice address

116 Ash Ave NW Ste 2
Wadena, MN 56482-1347

Phone

(218) 640-7368

NPI assigned

May 21, 2008

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shari Phillips, LLCGroup PAC ID 9537509336, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Shari Phillips LLC

  • Mental Health Counselor
  • Wadena, MN
  • NPI 1023691896
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1710144266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 3RD ST NW",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821118",
            "telephone_number": "218-640-7368",
            "fax_number": "218-640-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 ASH AVE NW STE 2",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821347",
            "telephone_number": "218-640-7368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 2nd St SW",
            "address_2": "SUITE 1",
            "address_purpose": "LOCATION",
            "city": "Wadena",
            "state": "MN",
            "postal_code": "564821417",
            "country_code": "US",
            "telephone_number": "218-631-1714",
            "fax_number": "218-631-4228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHARI",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Danielle Peterson
• Tabitha Ann Petrowski, MS, CCC-SLP
• Andrea C Pettit, PTA
• Jason Michael Pexsa, PHARM.D.
• Sam Phillips, R.PH.
• Mary Jo Pieper
• Kaylee Marie Poppen
• Leah Prussia, LICSW
• Jessica Radermacher, PA-C
• Amber Annice Rastedt, RN, BSN

• Mental Health Counselor in Wadena, MN
• Providers in Wadena, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.