Individual provider Active NPI

Lindsay Kruse, LIMHP, LPC

  • Professional Counselor
  • Omaha, NE
National Provider Identifier
1164562617
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3148 Issued in NE
Practice address
11510 Blondo St Ste 103
Omaha, NE 68164-3846
Phone
(402) 403-0190
Fax
(402) 932-4121
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3148 NE Primary

Addresses

Primary practice location

11510 Blondo St Ste 103
Omaha, NE 68164-3846

Mailing address

6923 S 197TH Cir
Gretna, NE 68028-3777
Phone (402) 312-5315

Other identifiers 2

IdentifierTypeStateIssuer
4737658526MedicaidNE
AUX98098OtherNEBLUECROSS BLUESHIELD

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
I20240710004465 NE Practitioner - Mental Health Counselor 4688777584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Attachment and Trauma Center of Nebraska LLCGroup PAC ID 5092879148, 12 clinicians

Practice addresses (Care Compare)

638 N 109TH PLZ
Omaha, NE 68154-1722
Phone (402) 403-0190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3148NEMDPhysical Therapist
270NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Attachment and Trauma Center of Nebraska, LLC CurrentSince May 1, 2024 Accepting new patients

Locations

638 N 109th Plz
Omaha, NE 68154
Phone (402) 345-2200

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1164562617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6923 S 197TH CIR",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680283777",
            "telephone_number": "402-312-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 BLONDO ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643846",
            "telephone_number": "402-403-0190",
            "fax_number": "402-932-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "LINDSAY",
        "credential": "LIMHP, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "3148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4737658526",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "AUX98098",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.