Individual provider Active NPI

Katherine Gallegos

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1063946705
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10401 Issued in NE
Practice address
11949 Q St
Omaha, NE 68137-3503
Phone
(402) 595-1565
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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 10401 NE Primary
Clinical Social Worker 1041C0700X 6957 NE

Addresses

Primary practice location

11949 Q St
Omaha, NE 68137-3503

Mailing address

5732 N 81St St
Omaha, NE 68134-2064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20240212001682 NE Practitioner - Mental Health Counselor 0244673762 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10401NEMDMental Health Counselor
6957NEMDLicensed Practical Nurse
2396NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Over Matter Counseling Services LLC CurrentSince Jan 7, 2024 Accepting new patients
Hope Collaborative LLC Mental Health Past Accepting new patients

Locations

5410 S 99th St
Omaha, NE 68127
Phone (402) 301-2312

955 N Adams St
Ste 8
Papillion, NE 68046
Phone (402) 339-0506

Organizations & group practices 2

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1063946705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5732 N 81ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681342064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11949 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373503",
            "telephone_number": "402-595-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10401",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "6957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.