Individual provider Active NPI

Michaela Gansen, APSW

  • Mental Health Counselor
  • La Crosse, WI
National Provider Identifier
1760076962
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
201 Main St Ste 500
La Crosse, WI 54601-0716
Phone
(507) 516-0030
NPI assigned
Feb 27, 2021
Last updated
Feb 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

201 Main St Ste 500
La Crosse, WI 54601-0716

Mailing address

1900 Silver Lake Rd NW
Saint Paul, MN 55112-1786
Phone (608) 386-2104

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230818000064 MN Practitioner - Clinical Social Worker 5890157176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30785MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hiawatha Valley Mental Health Center Inc. CurrentSince Jul 10, 2023 Accepting new patients
Woods Psychological Services LLC Mental Health Past Accepting new patients

Locations

611 Broadway Ave
Ste 100
Wabasha, MN 55981
Phone (651) 565-2234

420 E Sarnia St
Ste 2100
Winona, MN 55987
Phone (507) 454-4341

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1760076962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "608-386-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST STE 500",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546010716",
            "telephone_number": "507-516-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSEN",
        "first_name": "MICHAELA",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.