MEDICARE: TASHA JEAN RISCHMILLER LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CC02917	MN

General Provider Information

NPI Number	:	1346905056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TASHA JEAN RISCHMILLER LPCC

Provider Business Mailing Address
First Line	:	4900 US-169
Second Line	:	115
City	:	NEW HOPE
State	:	MN
Zip	:	55428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 BUCKSKIN CIR
Second Line	:
City	:	NEW CASTLE
State	:	CO
Zip	:	81647-9493
Country	:	US
Telephone Number	:	952-769-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	10/04/2023

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