NPIMap

Organization Active NPI

Wholeness Healing Center PC

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1124130364
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WHOLENESS HEALING CENTER PC
Practice address
2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone
(308) 382-5297
Fax
(308) 382-5315
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Ms. Jane L Watson, LCSWNPI 1770688657
Title
Owner, Director
Phone
(308) 382-5297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2608 Old Fair Rd
Grand Island, NE 68803-5271

Mailing address

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone (308) 382-5297

Other practice location 1

10361 Woodrose Ln
Highlands Ranch, CO 80129-5477
Phone (308) 382-5297

Other practice location 2

414 W Main St
Albion, NE 68620-1231
Phone (308) 382-5297

Other practice location 3

100 N 15th St
Ord, NE 68862-1458
Phone (308) 382-5297

Other identifiers 2

IdentifierTypeStateIssuer
10025173200MedicaidNE
10025173100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050105000266 NE Part B Supplier - Clinic/Group Practice 3173571320 Receives reassigned benefits from 19 practitioners
Practice locations: Grand Island, NE
O20210624001637 CO Part B Supplier - Clinic/Group Practice 3173571320 Receives reassigned benefits from 1 practitioner
Practice locations: Highlands Ranch, CO

National Provider Directory

National Provider Directory

Locations

414 W Main St
Albion, NE 68620
Phone (308) 382-5297

2222 2nd Ave
Ste 802
Kearney, NE 68847
Phone (308) 455-1560

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1124130364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10361 Woodrose Ln",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801295477",
            "country_code": "US",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "414 W Main St",
            "address_purpose": "LOCATION",
            "city": "Albion",
            "state": "NE",
            "postal_code": "686201231",
            "country_code": "US",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N 15th St",
            "address_purpose": "LOCATION",
            "city": "Ord",
            "state": "NE",
            "postal_code": "688621458",
            "country_code": "US",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHOLENESS HEALING CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER, DIRECTOR",
        "authorized_official_telephone_number": "308-382-5297",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173200",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.