Individual provider Active NPI

Michaela Monteverde, LPC-IT

  • Mental Health Counselor
  • Menasha, WI
National Provider Identifier
1801550900
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1478 Kenwood Dr Ste 1
Menasha, WI 54952-1161
Phone
(920) 886-9319
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 Primary

Addresses

Primary practice location

1478 Kenwood Dr Ste 1
Menasha, WI 54952-1161

Mailing address

1478 Kenwood Dr Ste 1
Menasha, WI 54952-1161
Phone (920) 886-9319

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
I20240214000167 WI Practitioner - Mental Health Counselor 0345684775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Counseling Center of the Fox Valley, Inc.Group PAC ID 9234034349, 11 clinicians

Practice addresses (Care Compare)

110 Church Ave
Oshkosh, WI 54901-4746
Phone 9208869319118

1205 Province Ter
Menasha, WI 54952-7017
Phone 9208869319118

709 W Pine St
Suite 1
New London, WI 54961-1643
Phone 9208869319118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Fox Valley, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1478 Kenwood Dr
Ste 1
Menasha, WI 54952
Phone (920) 886-9319

110 Church Ave
Oshkosh, WI 54901
Phone (920) 235-1678

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1801550900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 KENWOOD DR STE 1",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521161",
            "telephone_number": "920-886-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 KENWOOD DR STE 1",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521161",
            "telephone_number": "920-886-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEVERDE",
        "first_name": "MICHAELA",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.