Individual provider Active NPI

Ronda Marie Disch

  • Mental Health Counselor
  • Elk River, MN
National Provider Identifier
1861893505
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1306 Issued in MN
Practice address
11090 183Rd Cir NW Ste C
Elk River, MN 55330-2884
Phone
(763) 333-8001
NPI assigned
Sep 12, 2014
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 1306 MN Primary

Addresses

Primary practice location

11090 183Rd Cir NW Ste C
Elk River, MN 55330-2884

Mailing address

657 Main St NW Ste 5
Elk River, MN 55330-1584
Phone (763) 333-8001

Other practice location 1

4505 White Bear Pkwy Ste 2200
White Bear Lake, MN 55110-3699
Phone (763) 333-8001

Other names 1

  • Ronda Cooper Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ronda@emergencebh.com Direct

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

LicenseStateTypeSpecialty
1306MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peacetree Family Institute LTD CurrentSince Jan 20, 2024 Accepting new patients
Alpha Service Industries, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Forensic Mental Health Specialists CurrentSince Oct 12, 2018 Accepting new patients

Locations

199 Coon Rapids Blvd NW
Ste 102
Coon Rapids, MN 55433

2121 Cliff Dr
Ste 218
Eagan, MN 55122

11090 183rd Cir NW
Ste C
Elk River, MN 55330
Phone (763) 777-1381

657 Main St NW
Ste 5
Elk River, MN 55330

825 Nicollet Mall
Ste 1050
Minneapolis, MN 55402
Phone (612) 217-0447

14 7th Ave N
Saint Cloud, MN 56303
Phone (320) 259-4014

4505 White Bear Pkwy
Ste 2200
White Bear Lake, MN 55110
Phone (612) 590-3190

Organizations & group practices 3

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1861893505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 5",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301584",
            "telephone_number": "763-333-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11090 183RD CIR NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302884",
            "telephone_number": "763-333-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4505 White Bear Pkwy Ste 2200",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103699",
            "country_code": "US",
            "telephone_number": "763-333-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISCH",
        "first_name": "RONDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ronda@emergencebh.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11090 183rd Cir NW Ste C",
            "city": "Elk River",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553302884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RONDA",
            "last_name": "COOPER",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.