Micaella Maria Vandenboom, LPC in De Pere, WI

Micaella Maria Vandenboom, LPC is a medicare enrolled "Counselor - Professional" provider in De Pere, Wisconsin. Her current practice location is 1325 Angels Path, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 338-2855.

Micaella Maria Vandenboom is licensed to practice in Wisconsin (license number 7857-125) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1841969151.

Contact Information

	Micaella Maria Vandenboom, LPC
	1325 Angels Path, De Pere, WI 54115-4050
	(920) 338-2855
	(920) 338-9270

Map and Direction

Healthcare Provider's Profile

Full Name	Micaella Maria Vandenboom
Gender	Female
Speciality	Counselor - Professional
Location	1325 Angels Path, De Pere, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1841969151
Provider Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021

Medicare PECOS Information:

PECOS PAC ID: 3173974862
Enrollment ID: I20240106000762

Medical Identifiers

Medical identifiers for Micaella Maria Vandenboom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841969151	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	7857-125 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Micaella Maria Vandenboom allows following entities to bill medicare on her behalf.

Entity Name	Bellin Psychiatric Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952554800 PECOS PAC ID: 4486551058 Enrollment ID: O20031212000884

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Micaella Maria Vandenboom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Micaella Maria Vandenboom, LPC Po Box 22040, Green Bay, WI 54305-2040 Ph: (920) 445-7222	Micaella Maria Vandenboom, LPC 1325 Angels Path, De Pere, WI 54115-4050 Ph: (920) 338-2855

Reviews and Comments

Counselor in De Pere, WI

Craig Linzmeier, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1511 W Main Ave, Suite 100, De Pere, WI 54115 Phone: 920-403-7600 Fax: 920-403-7360
Cassandra Vanstraten, LPC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700
Mrs. Carole M St.laurent-groves, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1325 Angels Path Rd, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270
Andrew Johnson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 416 George St Ste B12, De Pere, WI 54115 Phone: 920-340-0939
Marie D. Ibarra Stafford, LPC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700
Mr. Dan J Braaten, LMFT, SAC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700
Stephanie Prevost, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700

Micaella Maria Vandenboom, LPC - Medicare Counselor in De Pere, WI