Individual provider Active NPI

Alexa Evon Demoe, LPC

  • Mental Health Counselor
  • Amery, WI
National Provider Identifier
1780240184
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8404-125 Issued in WI
Practice address
230 Deronda St
Amery, WI 54001-1412
Phone
(715) 268-8000
NPI assigned
May 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8404-125 WI Primary
Professional Counselor 101YP2500X 4173-226 WI

Addresses

Primary practice location

230 Deronda St
Amery, WI 54001-1412

Mailing address

PO Box 265
Shell Lake, WI 54871-0265

Other practice location 1

24670 State Road 35 70 Ste 700
Siren, WI 54872-4425
Phone (715) 468-2841

Other practice location 2

246 Industrial Blvd
Shell Lake, WI 54871-8889
Phone (715) 468-2841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240611000976 WI Practitioner - Mental Health Counselor 8628510278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians

Practice addresses (Care Compare)

265 Griffin E St
Amery, WI 54001-1439
Phone (715) 268-8000

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

Hospital & facility affiliations

  • Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8404-125WIMDMental Health Counselor
4173-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amery Regional Medical Center, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Soar Services, Inc. CurrentSince Mar 26, 2024 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince May 19, 2025 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince May 19, 2025 Accepting new patients
Turgeon Consulting Mental Health PastSince Aug 28, 2022 Accepting new patients

Locations

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

230 Deronda St
Deronda, WI 54001
Phone (715) 268-0060

246 Industrial Blvd
Shell Lake, WI 54871

24670 State Road 35 70
Ste 700
Siren, WI 54872

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1780240184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548710265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 DERONDA ST",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011412",
            "telephone_number": "715-268-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24670 State Road 35 70 Ste 700",
            "address_purpose": "LOCATION",
            "city": "Siren",
            "state": "WI",
            "postal_code": "548724425",
            "country_code": "US",
            "telephone_number": "715-468-2841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "246 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Shell Lake",
            "state": "WI",
            "postal_code": "548718889",
            "country_code": "US",
            "telephone_number": "715-468-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMOE",
        "first_name": "ALEXA",
        "middle_name": "EVON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8404-125",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4173-226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.