Individual provider Active NPI

John L Hall, PLMHP, PLADC

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1053822718
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11611 Issued in NE
Practice address
4600 Valley Rd Ste 425
Lincoln, NE 68510-4855
Phone
(402) 817-7312
NPI assigned
Oct 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X P-1126 NE
Mental Health Counselor 101YM0800X 11611 NE Primary

Addresses

Primary practice location

4600 Valley Rd Ste 425
Lincoln, NE 68510-4855

Mailing address

9633 Hollow Tree Dr
Lincoln, NE 68512-9535
Phone (402) 817-7312

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

LicenseStateTypeSpecialty
P-1126NEMDAddiction (Substance Use Disorder) Counselor
11611NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Support Services LLC CurrentSince Nov 26, 2023 Accepting new patients

Locations

4600 Valley Rd
Ste 425
Lincoln, NE 68510
Phone (402) 817-7312

10846 John Galt Blvd
Omaha, NE 68137
Phone (402) 325-1290

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1053822718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 HOLLOW TREE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685129535",
            "telephone_number": "402-817-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 425",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104855",
            "telephone_number": "402-817-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "PLMHP, PLADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-1126",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "11611",
            "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 Feb 13, 2019; 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.