Individual provider Active NPI

Kristine Wiley, LMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1093930489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
595 Issued in NE
Practice address
16940 Lakeside Hills PLZ
Suite 150
Omaha, NE 68130-2323
Phone
(402) 717-2555
Fax
(402) 572-3544
NPI assigned
Apr 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 595 NE Primary

Addresses

Primary practice location

16940 Lakeside Hills PLZ
Suite 150
Omaha, NE 68130-2323

Mailing address

PO Box 641130
Omaha, NE 68164-7130
Phone (402) 572-2907

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
I20231202000517 NE Practitioner - Mental Health Counselor 4587012422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4664
Phone (402) 758-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 758-5690

16940 Lakeside Hills Plz
Ste 150
Omaha, NE 68130
Phone (402) 717-2555

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

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, 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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093930489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641130",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647130",
            "telephone_number": "402-572-2907",
            "fax_number": "402-572-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16940 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 150",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302323",
            "telephone_number": "402-717-2555",
            "fax_number": "402-572-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KRISTINE",
        "credential": "LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.