Active NPI
Leyla Dim, LPC
- Mental Health Counselor
- Cody, WY
National Provider Identifier
1568612380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1102
- Practice address
- 331 Robert St
Cody, WY 82414-9268 - Phone
- (307) 587-6288
- NPI assigned
- Sep 29, 2008
- Last updated
- Jan 28, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1102 | WY | Primary |
Addresses
Primary practice location
331 Robert St
Cody, WY 82414-9268
Mailing address
PO Box 2444
Cody, WY 82414-2444
Phone (307) 587-6288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133438700 | Medicaid | WY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1102 | WY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Rising Counseling, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Cody, WY
- NPI 1205087962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1568612380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2444",
"city": "CODY",
"state": "WY",
"postal_code": "824142444",
"telephone_number": "307-587-6288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 ROBERT ST",
"city": "CODY",
"state": "WY",
"postal_code": "824149268",
"telephone_number": "307-587-6288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIM",
"first_name": "LEYLA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-29",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "1102",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133438700",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cody, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.