NPIMap

Individual provider Active NPI

Kipp Dana, LPC

  • Professional Counselor
  • Afton, WY
National Provider Identifier
1386825446
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-550 Issued in WY
Practice address
389 Adams
Afton, WY 83110-0376
Phone
(307) 885-9883
NPI assigned
Nov 16, 2007
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LAT-220 WY
Mental Health Counselor 101YM0800X LCPC3048 ID
Professional Counselor 101YP2500X LPC-550 WY Primary

Addresses

Primary practice location

389 Adams
Afton, WY 83110-0376

Mailing address

404 North Sprague Creek Rd.
P.O Box 24
Fairview, WY 83119-0024
Phone (307) 723-2252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025000674 WY Practitioner - Mental Health Counselor 6709213820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Country Behavioral HealthGroup PAC ID 0648454587, 44 clinicians

Practice addresses (Care Compare)

389 Adams St
Afton, WY 83110-5056
Phone (307) 885-9883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC3048IDMDMental Health Counselor
LPC-550WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Primary Care, LLC Mental Health Current Accepting new patients
High Country Behavioral Health Current Accepting new patients
High Country Behavioral Health CurrentSince Aug 19, 2024 Accepting new patients
High Country Behavioral Health CurrentSince Jun 27, 2011 Accepting new patients

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1386825446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 NORTH SPRAGUE CREEK RD.",
            "address_2": "P.O BOX 24",
            "city": "FAIRVIEW",
            "state": "WY",
            "postal_code": "831190024",
            "telephone_number": "307-723-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 ADAMS",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831100376",
            "telephone_number": "307-885-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANA",
        "first_name": "KIPP",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT-220",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC3048",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Afton, WY

Sources for this page

Verify at the official NPI Registry.