Individual provider Active NPI

Payton Michelle Krejdl, PLMHP, PLCSW

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1003649195
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8059 Issued in NE
Practice address
5539 S 27TH St
Lincoln, NE 68512-1648
Phone
(402) 435-2811
Fax
(402) 547-4186
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 14007
Clinical Social Worker 1041C0700X 8059 NE Primary

Addresses

Primary practice location

5539 S 27TH St
Lincoln, NE 68512-1648

Mailing address

5539 S 27TH St
Lincoln, NE 68512-1648
Phone (402) 435-2811

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

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1003649195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5539 S 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685121648",
            "telephone_number": "402-435-2811",
            "fax_number": "402-547-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5539 S 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685121648",
            "telephone_number": "402-435-2811",
            "fax_number": "402-547-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREJDL",
        "first_name": "PAYTON",
        "middle_name": "MICHELLE",
        "credential": "PLMHP, PLCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "14007",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "8059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.