Active NPI
Dylan Wren, LPC
- Professional Counselor
- Long Beach, MS
National Provider Identifier
1134842966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2425
- Practice address
- 5081 Beatline Rd
Long Beach, MS 39560-3814 - Phone
- (601) 439-6265
- NPI assigned
- Sep 26, 2022
- Last updated
- Sep 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2425 | MS | |
| Professional Counselor | 101YP2500X | 2425 | MS | Primary |
Addresses
Primary practice location
5081 Beatline Rd
Long Beach, MS 39560-3814
Mailing address
5081 Beatline Rd
Long Beach, MS 39560-3814
Phone (228) 806-7182
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 |
|---|---|---|---|
| 2425 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1134842966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5081 BEATLINE RD",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395603814",
"telephone_number": "228-806-7182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5081 BEATLINE RD",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395603814",
"telephone_number": "601-439-6265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WREN",
"first_name": "DYLAN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-26",
"last_updated": "2022-09-26",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "2425",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "2425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.