Active NPI
Darryl L Christianson, MS LCSW
- Professional Counselor
- Eau Claire, WI
National Provider Identifier
1689745473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3684
- Practice address
- 221 W Madison St
Eau Claire, WI 54703 - Phone
- (715) 832-5454
- Fax
- (715) 832-2991
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3684 | WI | Primary |
Addresses
Primary practice location
221 W Madison St
Eau Claire, WI 54703
Mailing address
221 W Madison St
Omne Clinic Inc
Eau Claire, WI 54703
Phone (715) 832-5454
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111741 | Other | WI | SECURITY HEALTH PLAN |
| 39238400 | Medicaid | WI | |
| HP69916 | Other | MN | HEALTH PARTNERS |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3684 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omne Clinic Inc | 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 and National Provider Directory roles.
-
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- Barron, WI
- NPI 1568573715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689745473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 W MADISON ST",
"address_2": "OMNE CLINIC INC",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "54703",
"telephone_number": "715-832-5454",
"fax_number": "715-832-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 W MADISON ST",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "54703",
"telephone_number": "715-832-5454",
"fax_number": "715-832-2991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSON",
"first_name": "DARRYL",
"middle_name": "L",
"credential": "MS LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURITY HEALTH PLAN",
"identifier": "111741",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39238400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP69916",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.