Individual provider Active NPI

David Robert Rynders, L.I.C.S.W.

  • Mental Health Counselor
  • Fairmont, MN
National Provider Identifier
1407097025
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LICSW#7581 Issued in MN
Practice address
301 Downtown Plaza
#3
Fairmont, MN 56031
Phone
(507) 735-8112
Fax
(507) 235-8110
NPI assigned
Mar 11, 2009
Last updated
Mar 11, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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 LICSW#7581 MN Primary

Addresses

Primary practice location

301 Downtown Plaza
#3
Fairmont, MN 56031

Mailing address

1407 South State St.
New Ulm, MN 56073
Phone (507) 354-3181

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
LICSW#7581MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Buffalo PastSince Jan 22, 2021 Accepting new patients
County of Chippewa PastSince Oct 18, 1999 Accepting new patients
Sioux Trails Mental Health Center, Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1407097025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 SOUTH STATE ST.",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "56073",
            "telephone_number": "507-354-3181",
            "fax_number": "507-354-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 DOWNTOWN PLAZA",
            "address_2": "#3",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "56031",
            "telephone_number": "507-735-8112",
            "fax_number": "507-235-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYNDERS",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LICSW#7581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.