Individual provider Active NPI

Debra Lynn Woods, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Plymouth, MN
National Provider Identifier
1407033434
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301203 Issued in MN
Practice address
1145 Shenandoah Lane
Adult Correction Facility, Assessor
Plymouth, MN 55447
Phone
(612) 596-0098
Fax
(763) 475-4297
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301203 MN Primary

Addresses

Primary practice location

1145 Shenandoah Lane
Adult Correction Facility, Assessor
Plymouth, MN 55447

Mailing address

1911 Pleasant Ave. South
Create Inc
Minneapolis, MN 55403
Phone (612) 874-9811

Other identifiers 1

IdentifierTypeStateIssuer
301203OtherMNLADC

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

LicenseStateTypeSpecialty
301203MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Resources for Education Alternative Treatments & Evaluation Addiction (Substance Use Disorder) Past Accepting new patients
Create Inc Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 2

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1407033434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 PLEASANT AVE. SOUTH",
            "address_2": "CREATE INC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55403",
            "telephone_number": "612-874-9811",
            "fax_number": "612-874-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SHENANDOAH LANE",
            "address_2": "ADULT CORRECTION FACILITY, ASSESSOR",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "612-596-0098",
            "fax_number": "763-475-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "301203",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.