Individual provider Active NPI

Coral Del Mar Nieves

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1134870454
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12864 Issued in NE
Practice address
2126 N 117TH Ave
Omaha, NE 68164-3670
Phone
(402) 415-8423
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 12864 NE Primary

Addresses

Primary practice location

2126 N 117TH Ave
Omaha, NE 68164-3670

Mailing address

2126 N 117TH Ave
Omaha, NE 68164-3670
Phone (402) 415-8423

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address c.nieves@omahaic.com Direct

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
I20240603002873 NE Practitioner - Mental Health Counselor 3274973508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7028 N 102ND Circle
Sirena Psychotherapy and Wellness
Omaha, NE 68122-3059
Phone (402) 780-1661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12864NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sirena Psychotherapy and Wellness LLC Mental Health CurrentSince Mar 26, 2024 Accepting new patients

Locations

7028 N 102nd Cir
Omaha, NE 68122
Phone (402) 780-1661

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1134870454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-415-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-415-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "CORAL",
        "middle_name": "DEL MAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "c.nieves@omahaic.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2126 N 117th Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681643670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.