Individual provider Active NPI

Rachael M Bogacz, LICSW, LIMHP

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1033739537
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3770 Issued in NE
Practice address
2602 J St
Omaha, NE 68107-1643
Phone
(402) 733-3612
Fax
(402) 933-9657
NPI assigned
Apr 24, 2020
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3770 NE Primary

Addresses

Primary practice location

2602 J St
Omaha, NE 68107-1643

Mailing address

2602 J St
Omaha, NE 68107-1643
Phone (402) 733-3612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240925003075 TX Practitioner - Mental Health Counselor 8022559400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Paths Healing and Wellness LLC Mental Health Current Accepting new patients
Ponca Tribe of Nebraska CurrentSince Aug 6, 2024 Accepting new patients
Ponca Tribe of Nebraska PastSince Jul 4, 2021 Accepting new patients

Locations

2602 J St
Omaha, NE 68107
Phone (402) 733-3612

5805 S 86th Cir
Ralston, NE 68127

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1033739537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-733-3612",
            "fax_number": "402-933-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-733-3612",
            "fax_number": "402-933-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGACZ",
        "first_name": "RACHAEL",
        "middle_name": "M",
        "credential": "LICSW, LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "3770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.