Individual provider Active NPI

Richard Deboest, LMHC, LCAC

  • Mental Health Counselor
  • Pierceton, IN
National Provider Identifier
1518223676
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001573A Issued in IN
Practice address
27 Pequignot Dr
Pierceton, IN 46562-9081
Phone
(574) 594-9200
Fax
(574) 594-9031
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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 39001573A IN Primary

Addresses

Primary practice location

27 Pequignot Dr
Pierceton, IN 46562-9081

Mailing address

103 Freedom LN
Winona Lake, IN 46590-1431
Phone (574) 267-3426

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
39001573AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1518223676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FREEDOM LN",
            "city": "WINONA LAKE",
            "state": "IN",
            "postal_code": "465901431",
            "telephone_number": "574-267-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 PEQUIGNOT DR",
            "city": "PIERCETON",
            "state": "IN",
            "postal_code": "465629081",
            "telephone_number": "574-594-9200",
            "fax_number": "574-594-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOEST",
        "first_name": "RICHARD",
        "credential": "LMHC, LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001573A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pierceton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.