Individual provider Active NPI

Jennifer L Spencer, MS, LIMHP, LADC

  • Mental Health Counselor
  • North Platte, NE
National Provider Identifier
1154601250
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4325 Issued in NE
Practice address
110 N Bailey Ave
North Platte, NE 69101-5436
Phone
(308) 534-6029
Fax
(308) 534-6961
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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 4325 NE Primary

Addresses

Primary practice location

110 N Bailey Ave
North Platte, NE 69101-5436

Mailing address

110 N Bailey Ave
PO Box 1209
North Platte, NE 69101-5436
Phone (308) 534-6029

Other practice location 1

321 E State St
Brady, NE 69123-3043
Phone (402) 917-0334

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
I20240821002134 NE Practitioner - Mental Health Counselor 3375081300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Nebraska College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 N Main St
Brady, NE 69123-2749
Phone (402) 917-0334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1365NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Graceful Warrior Counseling and Consulting LLC Mental Health CurrentSince Jul 2, 2024 Accepting new patients
Region II Human Services Past Accepting new patients

Locations

120 N Main St
Brady, NE 69123
Phone (402) 917-0334

Organizations & group practices 2

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1154601250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N BAILEY AVE",
            "address_2": "PO BOX 1209",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015436",
            "telephone_number": "308-534-6029",
            "fax_number": "308-534-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N BAILEY AVE",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015436",
            "telephone_number": "308-534-6029",
            "fax_number": "308-534-6961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 E State St",
            "address_purpose": "LOCATION",
            "city": "Brady",
            "state": "NE",
            "postal_code": "691233043",
            "country_code": "US",
            "telephone_number": "402-917-0334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MS, LIMHP, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.