NPIMap

Organization Active NPI

Homebase Counseling & Consulting, LLC

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1154510394
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
57 Issued in NE
Legal business name
HOMEBASE COUNSELING & CONSULTING, LLC
Practice address
2001 N 35TH St
Omaha, NE 68111-4133
Phone
(615) 853-1254
NPI assigned
Oct 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Authorized official

Name
Mr. Justin M Mickles Sr., MSNPI 1649266388
Title
Owner/Mental Health Therapist
Phone
(615) 853-1254

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1485 NE
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 57 NE Primary

Addresses

Primary practice location

2001 N 35TH St
Omaha, NE 68111-4133

Mailing address

5646 Amalie Dr Apt F101
Nashville, TN 37211-5941
Phone (615) 853-1254

Other identifiers 1

IdentifierTypeStateIssuer
10025595100MedicaidNE

National Provider Directory

National Provider Directory

Locations

2001 N 35th St
Omaha, NE 68111
Phone (615) 853-1254

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1154510394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5646 AMALIE DR APT F101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115941",
            "telephone_number": "615-853-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N 35TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681114133",
            "telephone_number": "615-853-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEBASE COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "MICKLES",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "615-853-1254",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1485",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025595100",
            "state": "NE"
        }
    ],
    "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 Sep 28, 2015; 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.