Organization Active NPI

Wishing Well Counseling LLC

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1154959187
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WISHING WELL COUNSELING LLC
Practice address
4444 S 86TH St St.
Suite 102
Lincoln, NE 68526-9253
Phone
(402) 476-7557
Fax
(402) 476-9912
NPI assigned
Mar 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Becky Haumont
Title
Office Manager
Phone
(402) 476-7557

Specialties & licenses 1

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

Addresses

Primary practice location

4444 S 86TH St St.
Suite 102
Lincoln, NE 68526-9253

Mailing address

4444 S 86TH St St.
Suite 102
Lincoln, NE 68526-9253
Phone (402) 476-7557

Other identifiers 1

IdentifierTypeStateIssuer
60096287201MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240701000153 NE Part B Supplier - Clinic/Group Practice 4183168263 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

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": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1154959187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 S 86TH ST ST.",
            "address_2": "SUITE 102",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269253",
            "telephone_number": "402-476-7557",
            "fax_number": "402-476-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 S 86TH ST ST.",
            "address_2": "SUITE 102",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269253",
            "telephone_number": "402-476-7557",
            "fax_number": "402-476-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISHING WELL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-09-26",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "HAUMONT",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-476-7557"
    },
    "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": "60096287201",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.