Active NPI
Samuel Kingery
- Mental Health Counselor
- Lincoln, NE
National Provider Identifier
1033009337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14499
- Practice address
- 3833 S 14TH St
Lincoln, NE 68502-5340 - Phone
- (402) 937-8323
- NPI assigned
- Jul 8, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14499 | NE | Primary |
Addresses
Primary practice location
3833 S 14TH St
Lincoln, NE 68502-5340
Mailing address
4749 Duxhall Dr
Lincoln, NE 68516-3116
Phone (402) 217-5605
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 |
|---|---|---|---|
| 14499 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspring Behavior Health LLC | Mental Health | Current | Accepting new patients |
Locations
3833 S 14th St
Lincoln, NE 68502
Phone (402) 937-8323
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1033009337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4749 DUXHALL DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685163116",
"telephone_number": "402-217-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3833 S 14TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685025340",
"telephone_number": "402-937-8323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGERY",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-07-08",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "14499",
"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 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.