Active NPI
Melinda M Pedersen
- Professional Counselor
- Twin Lakes, WI
National Provider Identifier
1932548583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6523-125
- Practice address
- 310 Lance Dr.
Suite 210
Twin Lakes, WI 53181 - Phone
- (608) 295-4797
- NPI assigned
- Jun 17, 2013
- Last updated
- May 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6523-125 | WI | Primary |
Addresses
Primary practice location
310 Lance Dr.
Suite 210
Twin Lakes, WI 53181
Mailing address
310 Lance Dr.
Suite 210
Twin Lakes, WI 53181
Phone (608) 400-4320
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 |
|---|---|---|---|
| 6523-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cup of Thoughts Therapy, LLC | Professional | Current | 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": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1932548583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 LANCE DR.",
"address_2": "SUITE 210",
"city": "TWIN LAKES",
"state": "WI",
"postal_code": "53181",
"telephone_number": "608-400-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 LANCE DR.",
"address_2": "SUITE 210",
"city": "TWIN LAKES",
"state": "WI",
"postal_code": "53181",
"telephone_number": "608-295-4797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSEN",
"first_name": "MELINDA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-17",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6523-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Lakes, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.