Micaella Maria Vandenboom, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7857-125 Issued in WI

Practice address

1325 Angels Path
De Pere, WI 54115-4050

Phone

(920) 338-2855

Fax

(920) 338-9270

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

No

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  WI

  Medicare reassignment Care Compare group NPD
• Bellin Psychiatric Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1952554800

  WI

  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390

  Professional

  Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Green Bay, WI
  • NPI 1518920883
  Care Compare group
• Bellin Memorial Hospital Inc

  • Home Infusion Therapy Pharmacy
  • Green Bay, WI
  • NPI 1619078094
  Care Compare group
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Kewaunee, WI
  • NPI 1699737379
  Care Compare group
• Bellin Memorial Hospital Inc

  • Mobile Radiology Clinic/Center
  • Green Bay, WI
  • NPI 1740600600
  Care Compare group
• Bellin Memorial Hospital Inc

  • Home Health Agency
  • Green Bay, WI
  • NPI 1831246404
  Care Compare group
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare group
• Bellin Memorial Hospital, Inc

  • Rehabilitation Hospital Unit
  • Green Bay, WI
  • NPI 1174689178
  Care Compare group
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509
  Care Compare group
• Bellin Memorial Hospital Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Green Bay, WI
  • NPI 1679983183
  NPD

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital Inc 685 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

• Micaella M Schneider Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 9, 2021.

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1841969151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANGELS PATH",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154050",
            "telephone_number": "920-338-2855",
            "fax_number": "920-338-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOOM",
        "first_name": "MICAELLA",
        "middle_name": "MARIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7857-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICAELLA",
            "last_name": "SCHNEIDER",
            "middle_name": "M",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aspen Marie Van Straten, APNP
• Candace N Van Veghel, MS, CCC-SLP
• Kate Marie Vanalstyne, OT
• Faith Marie Vandenberg, PTA
• Mitchell Vandenboogard
• Ashley Marie Vandermoss, APSW
• Kelly Rae Vandermuss, PA-C
• Michelle Vandewettering
• Kaunhou Vang
• Crystal Lynn Vankauwenberg, LPC

• All providers in De Pere, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.