NPIMap

Organization Active NPI

Winds of Change Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dickinson, ND
National Provider Identifier
1295367449
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WINDS OF CHANGE COUNSELING SERVICES LLC
Practice address
30 7TH St. W, Door a
Dickinson, ND 58601
Phone
(701) 483-0230
Fax
(701) 483-0231
NPI assigned
Feb 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Dr. Shelly M Hall, PSYDNPI 1336115435
Title
Clinical Psychological
Phone
(701) 483-0230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

30 7TH St. W, Door a
Dickinson, ND 58601

Mailing address

PO Box 810
Dickinson, ND 58602-0810
Phone (701) 483-0230

Other practice location 1

1126 11th Ave E
Dickinson, ND 58601-4205
Phone (701) 290-5206

Other names 1

  • Winds of Change Counseling Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201023002908 ND Part B Supplier - Clinic/Group Practice 8022438415 Receives reassigned benefits from 2 practitioners
Practice locations: Dickinson, ND

National Provider Directory

National Provider Directory

Locations

30 7th St W
#A
Dickinson, ND 58601
Phone (701) 483-0230

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1295367449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586020810",
            "telephone_number": "701-483-0230",
            "fax_number": "701-483-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH ST. W, DOOR A",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "58601",
            "telephone_number": "701-483-0230",
            "fax_number": "701-483-0231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1126 11th Ave E",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "586014205",
            "country_code": "US",
            "telephone_number": "701-290-5206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WINDS OF CHANGE COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGICAL",
        "authorized_official_telephone_number": "701-483-0230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winds of Change Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Winds of Change Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.