Active NPI
Michelle Kay Root-McDaniel
- School Psychologist
- Eagle River, WI
National Provider Identifier
1851999163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 835100
- Practice address
- 846 Metaloon Trail
Eagle River, WI 54521 - Phone
- (832) 439-4097
- NPI assigned
- Oct 9, 2020
- Last updated
- Oct 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 835100 | WI | Primary |
Addresses
Primary practice location
846 Metaloon Trail
Eagle River, WI 54521
Mailing address
846 Metaloon Trail
Eagle River, WI 54521
Phone (832) 439-4097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 835100 | WI | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Clinic, LLC | School | Past | Accepting new patients |
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, 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": "1602201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1851999163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "846 METALOON TRAIL",
"city": "EAGLE RIVER",
"state": "WI",
"postal_code": "54521",
"telephone_number": "832-439-4097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "846 METALOON TRAIL",
"city": "EAGLE RIVER",
"state": "WI",
"postal_code": "54521",
"telephone_number": "832-439-4097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOT-MCDANIEL",
"first_name": "MICHELLE",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-09",
"last_updated": "2020-10-09",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "835100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle River, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.