Individual provider Active NPI

Janice I Tetherow, MA,CPC,LMHP,NCC

  • Mental Health Counselor
  • Valentine, NE
National Provider Identifier
1114027067
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1754 Issued in NE
Practice address
442 N Cherry St
Valentine, NE 69201-1516
Phone
(402) 376-1000
NPI assigned
Sep 22, 2006
Last updated
Nov 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1754 NE Primary
Mental Health Counselor 101YM0800X 387 NE
Professional Counselor 101YP2500X 1051 NE

Addresses

Primary practice location

442 N Cherry St
Valentine, NE 69201-1516

Mailing address

442 N Cherry St
Valentine, NE 69201-1516
Phone (402) 376-1000

Other identifiers 3

IdentifierTypeStateIssuer
11555OtherMIDLANDS CHOICE
47055423826MedicaidNE
84907OtherNEBLUE CROSS BLUE SHIELD

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1754NEMDRegistered Dietitian
1051NEMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1114027067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 N CHERRY ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011516",
            "telephone_number": "402-376-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N CHERRY ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011516",
            "telephone_number": "402-376-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETHEROW",
        "first_name": "JANICE",
        "middle_name": "I",
        "credential": "MA,CPC,LMHP,NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1754",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "387",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1051",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "11555",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055423826",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84907",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valentine, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.