Individual provider Active NPI

Paul D Winkler, PSYD

  • Mental Health Counselor
  • Traverse City, MI
National Provider Identifier
1306082821
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6301005613 Issued in MI
Practice address
512 S Union St
Traverse City, MI 49684-3247
Phone
(231) 941-6550
Fax
(231) 941-8981
NPI assigned
Jan 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6301005613 MI Primary

Addresses

Primary practice location

512 S Union St
Traverse City, MI 49684-3247

Mailing address

20420 Betsie Highland Dr
Interlochen, MI 49643-9314
Phone (231) 275-0454

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301005613MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Old Town Psychological Services-Gaylord Past Accepting new patients
Seniors Wellness Group of Michigan, P.C. Clinical Past Accepting new patients
Old Town Psychological Services Clinical PastSince Jun 15, 2012 Accepting new patients

Organizations & group practices 3

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": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1306082821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20420 BETSIE HIGHLAND DR",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439314",
            "telephone_number": "231-275-0454",
            "fax_number": "231-275-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843247",
            "telephone_number": "231-941-6550",
            "fax_number": "231-941-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKLER",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-06",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301005613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.