Jody L Detwieler, LIMHP, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2608 Old Fair Rd
Grand Island, NE 68803-5271

Phone

(308) 382-5297

Fax

(308) 382-5315

NPI assigned

Apr 26, 2007

Last updated

Apr 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jody L Dye Former name

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wholeness Healing Center PCGroup PAC ID 3173571320, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wholeness Healing Center PC

  • Mental Health Counselor
  • Grand Island, NE
  • NPI 1124130364
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1962622746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWIELER",
        "first_name": "JODY",
        "middle_name": "L",
        "credential": "LIMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006022486",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "DYE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ariel Lachandra Derr, PLMHP, NCC
• Linette Derr
• Tara Desel
• Stephanie Detamore
• Megan R Dethlefsen, PHARM.D
• Madelayne Deus Olivares
• Jennifer Jill Dexter
• Lisandra Rafaela Diaz Goite
• Arlety Diaz Rodriguez
• Angelina Diaz

• Mental Health Counselor in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.