Dionne Dynlacht, PHD, HSPP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

20041360A Issued in IN

Practice address

12647 Geist Cove Dr
Indianapolis, IN 46236-7239

Phone

(317) 826-4205

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dionne.dynlacht.p1@direct.adultandchild.nextgenshare.com

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.

• Adult and Child Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1154368512
  Medicare reassignment NPD
• Adult and Child Center

  • Multi-Specialty Clinic/Center
  • Indianapolis, IN
  • NPI 1669770178
  NPD
• Adult and Child Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1083432272
  NPD
• Children'S Bureau, Inc.

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1154460624
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1972547693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12647 GEIST COVE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 GEIST COVE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367239",
            "telephone_number": "317-826-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYNLACHT",
        "first_name": "DIONNE",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "20041360A",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IN",
            "license": "20041360A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041360A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041360A",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": "20041360A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201057980",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100323760A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000849448",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Andrew T Dysangco, MD
• Evelyn Antoinette Dysarz, D.C.
• Donae Dyson
• Holly Dyson
• Jerry L Dyson Jr.

• Clinical Child & Adolescent Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Child & Adolescent Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.