Organization Active NPI

Phoenix Counseling

  • Mental Health Counselor
  • Moorhead, MN
National Provider Identifier
1861215865
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PHOENIX COUNSELING
Practice address
725 Center Ave Ste 3
Moorhead, MN 56560-1972
Phone
(218) 366-6162
NPI assigned
Nov 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Marsha M Wichmann, MA, LPCC, LADC, LACNPI 1073901666
Title
Co-Owner
Phone
(701) 367-1079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

725 Center Ave Ste 3
Moorhead, MN 56560-1972

Mailing address

725 Center Ave Ste 3
Moorhead, MN 56560-1972
Phone (218) 366-6162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250227000221 MN Part B Supplier - Clinic/Group Practice 2264952704 Receives reassigned benefits from 3 practitioners
Practice locations: Moorhead, MN

National Provider Directory

National Provider Directory

Locations

725 Center Ave
Ste 3
Moorhead, MN 56560
Phone (218) 366-6162

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1861215865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE STE 3",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601972",
            "telephone_number": "218-366-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CENTER AVE STE 3",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601972",
            "telephone_number": "218-366-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "WICHMANN",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "701-367-1079",
        "authorized_official_credential": "MA, LPCC, LADC, LAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.