Debra Lynn Wine, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801019767 Issued in MI

Practice address

309 Huron Ave
Port Huron, MI 48060-3869

Phone

(810) 689-9899

NPI assigned

May 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Debra Lynn Collins Former name

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Michigan State University College of Human Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JJL Consultants LLCGroup PAC ID 4789978743, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• JJL Consultants LLC

  • Clinical Social Worker
  • Port Huron, MI
  • NPI 1497101695

  Clinical, MI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1508487489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 EDISON BLVD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602116",
            "telephone_number": "810-650-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603869",
            "telephone_number": "810-689-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801019767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thmbcoastcounseling@thumbcoastcounseling.com",
            "affiliation": "N",
            "address_1": "309 Huron Ave",
            "city": "Port Huron",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480603869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thmbcoastcounseling@thumbcoastcounseling.com",
            "affiliation": "N",
            "address_1": "309 Huron Ave",
            "city": "Port Huron",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480603869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thmbcoastcounseling@thumbcoastcounseling.com",
            "affiliation": "N",
            "address_1": "309 Huron Ave",
            "city": "Port Huron",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480603869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thmbcoastcounseling@thumbcoastcounseling.com",
            "affiliation": "N",
            "address_1": "309 Huron Ave",
            "city": "Port Huron",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480603869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "COLLINS",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Wilson-Vani, RN FNP-C
• Ashley Lauren Wilson, PA-C
• Jenne Wilson
• Tammy Sue Wilson, LPC
• Joseph Windhorst, LMSW
• Rachel Nicole Winters Graham
• Samantha Winward-Maes
• Aleesha Pearl Wise, FNP-C
• Jack Randall Withenshaw, SW, LMFT
• Christine Marie Wohlfield, MSW, LLMSW

• All providers in Port Huron, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.