DELTA CENTER OF WISCONSIN
NPI 1104688365
Psychologist - Counseling in Fond Du Lac, WI

Active since January 24, 2024
196 3RD ST, FOND DU LAC, WI 54935(920) 733-2065 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 24, 2024, Apr 17, 2024 (2 updates tracked since 2024).

About Delta Center Of Wisconsin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DELTA CENTER OF WISCONSIN (NPI 1104688365) is a healthcare organization registered as a counseling in Fond Du Lac, Wisconsin and active in the NPI registry since January 2024. The organization lists Leslie Johnson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104688365
Entity TypeOrganization
Primary Taxonomy103TC1900X
Legal Business NameOPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Location Address196 3RD STFond Du Lac, WI 54935-4418
Mailing Address11000 Optum CirEden Prairie, MN 55344-2503 · (704) 506-6267
Organization SubpartNo
Authorized OfficialLeslie JohnsonCeo · (704) 506-6267
Enumeration DateJanuary 24, 2024
Last NPPES UpdateApril 24, 20242 updates tracked since enumeration
NPPES CertifiedApril 24, 2024
✔ NPI 1104688365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · CounselingBehavioral Health & Social Service Providers
Taxonomy Code103TC1900X
Definition
A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
196 3RD ST, Fond Du Lac, WI 54935

Other Names 1

Doing Business AsDelta Center Of Wisconsin

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Delta Center Of Wisconsin is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Delta Center Of Wisconsin, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Clinical Social Worker
NPI 1184642746
1806 E FIR AVE SUITE 500
Fergus Falls, MN 56537
(218) 205-2743
✔ PECOS✔ Accepts Medicare411 mi
Clinical Social Worker
NPI 1376157313
217 FALLSBROOK RD
Timonium, MD 21093
(443) 465-8795
✔ PECOS680 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Optum Behavioral Care Of Colorado, P.C.'s NPI number?

The NPI number for Optum Behavioral Care Of Colorado, P.C. is 1104688365. It was assigned to this organization in the NPPES registry on January 24, 2024. The provider is doing business as Delta Center Of Wisconsin.

Where is Optum Behavioral Care Of Colorado, P.C. located?

Optum Behavioral Care Of Colorado, P.C. is located at 196 3rd St, Fond Du Lac, WI 54935. The listed phone number is (920) 733-2065.

What is Optum Behavioral Care Of Colorado, P.C.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Counseling, with taxonomy code 103TC1900X.

Is Optum Behavioral Care Of Colorado, P.C. enrolled in Medicare?

Yes. Optum Behavioral Care Of Colorado, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Optum Behavioral Care Of Colorado, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Clinical Social Worker, reassign their Medicare billing to Optum Behavioral Care Of Colorado, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Optum Behavioral Care Of Colorado, P.C. accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Dean Health Plan list Optum Behavioral Care Of Colorado, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Optum Behavioral Care Of Colorado, P.C. was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.