Dwane Wynne LPC PA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DWANE WYNNE LPC PA

Practice address

356 Grovers Knob
Blowing Rock, NC 28605-9012

Phone

(919) 618-7120

NPI assigned

May 21, 2024

Last updated

May 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald Dwane Wynne, LCMHCSNPI 1043267412

Title

President

Phone

(919) 618-7120

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald Dwane Wynne, LCMHCS

  • Mental Health Counselor
  • Blowing Rock, NC
  • NPI 1043267412
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1659110567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 GROVERS KNOB",
            "city": "BLOWING ROCK",
            "state": "NC",
            "postal_code": "286059012",
            "telephone_number": "919-618-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 GROVERS KNOB",
            "city": "BLOWING ROCK",
            "state": "NC",
            "postal_code": "286059012",
            "telephone_number": "919-618-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWANE WYNNE LPC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "DWANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-618-7120",
        "authorized_official_credential": "LCMHCS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Blowing Rock, NC
• Providers in Blowing Rock, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.