Infinite Change Family Therapy Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INFINITE CHANGE FAMILY THERAPY CENTER LLC

Practice address

245 S 84TH St Ste L101
Lincoln, NE 68510-2601

Phone

(402) 421-1182

Fax

(402) 465-8717

NPI assigned

Aug 18, 2018

Organization subpart

No

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

Authorized official

Name

Kadra Omerovic

Title

Credentialing

Phone

(402) 421-1182

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Marie Wagner, LCSW

  • Clinical Social Worker
  • Lincoln, NE
  • NPI 1366998528
  Medicare reassignment
• Kathy Dee Tejcka, LMHP, MSW

  • Mental Health Counselor
  • Lincoln, NE
  • NPI 1124466503
  NPD (past)
• Tonya Walker

  • Mental Health Counselor
  • Questa, NM
  • NPI 1205482833
  NPD (past)

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

{
    "created_epoch": "1534550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534550400000",
    "number": "1093295065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S 84TH ST STE L101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102601",
            "telephone_number": "402-421-1182",
            "fax_number": "402-465-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S 84TH ST STE L101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102601",
            "telephone_number": "402-421-1182",
            "fax_number": "402-465-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE CHANGE FAMILY THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-18",
        "last_updated": "2018-08-18",
        "status": "A",
        "authorized_official_last_name": "OMEROVIC",
        "authorized_official_first_name": "KADRA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "402-421-1182"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50896891202",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inclusive ABA NE
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• Independent Horizons, LLC
• Indian Center, Inc (Many Nations Healing Counseling Services)
• Mignonne Ingabire
• David Lynn Ingersoll
• Nancy J Ingham, MD
• Scott Thomas Ingham, MD
• William K Ingham, M.D.

• Mental Health Counselor in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.