Active NPI
Heidi Lynn Whiteaker Duderstadt, LCPC, LAC
- Professional Counselor
- Ottawa, KS
National Provider Identifier
1831530955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2333
- Practice address
- 213 S Main St
Ottawa, KS 66067-2329 - Phone
- (785) 915-9452
- Fax
- (785) 748-4761
- NPI assigned
- Jul 17, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 943 | KS | |
| Professional Counselor | 101YP2500X | 2333 | KS | Primary |
Addresses
Primary practice location
213 S Main St
Ottawa, KS 66067-2329
Mailing address
213 S Main St
Ottawa, KS 66067-2329
Phone (785) 915-9452
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201146140A | Medicaid | KS |
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 |
|---|---|---|---|
| 943 | KS | MD | Addiction (Substance Use Disorder) Counselor |
| 2333 | KS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1831530955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 S MAIN ST",
"city": "OTTAWA",
"state": "KS",
"postal_code": "660672329",
"telephone_number": "785-915-9452",
"fax_number": "785-748-4761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 S MAIN ST",
"city": "OTTAWA",
"state": "KS",
"postal_code": "660672329",
"telephone_number": "785-915-9452",
"fax_number": "785-748-4761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEAKER DUDERSTADT",
"first_name": "HEIDI",
"middle_name": "LYNN",
"credential": "LCPC, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "KS",
"license": "943",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "2333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201146140A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ottawa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.