Individual provider Active NPI

Mary Alison Signorelli

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1114634318
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13080 Issued in NE
Practice address
1941 S 42ND St Ste 328
Omaha, NE 68105-2943
Phone
(402) 614-8444
Fax
(402) 614-8443
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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 13080 NE Primary
Clinical Social Worker 1041C0700X 7751 NE

Addresses

Primary practice location

1941 S 42ND St Ste 328
Omaha, NE 68105-2943

Mailing address

1400 Franklin Ave Apt 24
Council Bluffs, IA 51503-5243
Phone (402) 320-5218

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
13080NEMDMental Health Counselor
7751NEMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1114634318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FRANKLIN AVE APT 24",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035243",
            "telephone_number": "402-320-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 S 42ND ST STE 328",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052943",
            "telephone_number": "402-614-8444",
            "fax_number": "402-614-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGNORELLI",
        "first_name": "MARY",
        "middle_name": "ALISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "13080",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "7751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.