Individual provider Active NPI

Deon J Wynia, M.A., LMHC

  • Counselor
  • Orange City, IA
National Provider Identifier
1720187867
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
00291 Issued in IA
Practice address
400 Central Ave NW Ste 300
Suite 103
Orange City, IA 51041-1332
Phone
(712) 737-2635
Fax
(712) 737-2344
NPI assigned
Sep 22, 2006
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 00291 IA Primary

Addresses

Primary practice location

400 Central Ave NW Ste 300
Suite 103
Orange City, IA 51041-1332

Mailing address

400 Central Ave NW Ste 300
Suite 103
Orange City, IA 51041-1332
Phone (712) 737-2635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231226001541 IA Practitioner - Mental Health Counselor 0648620161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethesda Christian Counseling Midwest IncGroup PAC ID 6608869078, 9 clinicians

Practice addresses (Care Compare)

400 Central Ave NW
Suite 300
Orange City, IA 51041-1332
Phone (712) 737-2635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
00291IAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Christian Counseling Midwest, Inc. Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

400 Central Ave NW
Ste 300
Orange City, IA 51041
Phone (712) 737-2635

400 S Sycamore Ave
Ste 105-3
Sioux Falls, SD 57110
Phone (605) 334-3739

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1720187867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE NW STE 300",
            "address_2": "SUITE 103",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411332",
            "telephone_number": "712-737-2635",
            "fax_number": "712-737-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE NW STE 300",
            "address_2": "SUITE 103",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411332",
            "telephone_number": "712-737-2635",
            "fax_number": "712-737-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNIA",
        "first_name": "DEON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.A., LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "00291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, IA

Sources for this page

Verify at the official NPI Registry.