Individual provider Active NPI

Debra Charmaine Viner, PHD

  • Clinical Psychologist
  • Duluth, MN
National Provider Identifier
1003866922
Registry record updated Jan 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1868 Issued in MN
Practice address
306 W Superior St Ste 1000
Duluth, MN 55802-1818
Phone
(218) 481-7660
Fax
(218) 216-1452
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LP1868 MN
Clinical Psychologist 103TC0700X 1868 MN Primary

Addresses

Primary practice location

306 W Superior St Ste 1000
Duluth, MN 55802-1818

Mailing address

306 W Superior St
Ste 1000
Duluth, MN 55802-1818
Phone (218) 428-1175

Other practice location 1

220 N 6th Ave E
Duluth, MN 55805-1952
Phone (218) 249-7000

Other identifiers 1

IdentifierTypeStateIssuer
275252200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000418 MN Practitioner - Clinical Psychologist 6305883323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Insight Counseling Duluth LLC 13 clinicians

Practice addresses (Care Compare)

225 1St St N
Suite 3100B
Virginia, MN 55792-2457
Phone (218) 481-7660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP1868MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Counseling Duluth, LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

306 W Superior St
Ste 1000
Duluth, MN 55802
Phone (218) 428-1175

225 1st St N
Ste 3100B
Virginia, MN 55792
Phone (218) 481-7660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1003866922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W SUPERIOR ST",
            "address_2": "STE 1000",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021818",
            "telephone_number": "218-428-1175",
            "fax_number": "218-216-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W SUPERIOR ST STE 1000",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021818",
            "telephone_number": "218-481-7660",
            "fax_number": "218-216-1452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N 6th Ave E",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051952",
            "country_code": "US",
            "telephone_number": "218-249-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINER",
        "first_name": "DEBRA",
        "middle_name": "CHARMAINE",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "LP1868",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "1868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275252200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.