Individual provider Active NPI

Courtney Goracke

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1174394944
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2833
Practice address
2202 S 11TH St
Lincoln, NE 68502-3559
Phone
(402) 475-5161
NPI assigned
Jan 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1434 NE
Mental Health Counselor 101YM0800X 2833 Primary

Addresses

Primary practice location

2202 S 11TH St
Lincoln, NE 68502-3559

Mailing address

2633 P St
Lincoln, NE 68503-3528
Phone (402) 475-5161

Other practice location 1

1490 N 16th St
Omaha, NE 68102-4101
Phone (402) 870-0570

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
I20240301001441 NE Practitioner - Clinical Social Worker 6507201498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerpointe IncGroup PAC ID 8123063237, 11 clinicians

Practice addresses (Care Compare)

2202 S 11TH St
Lincoln, NE 68502-3559
Phone (402) 475-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1979NEMDDental Hygienist
1434NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerpointe, Inc. Addiction (Substance Use Disorder) CurrentSince Jan 10, 2024 Accepting new patients

Locations

2202 S 11th St
Lincoln, NE 68502
Phone (402) 475-5161

2633 P St
Lincoln, NE 68503
Phone (402) 475-5161

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": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1174394944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 P ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033528",
            "telephone_number": "402-475-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S 11TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023559",
            "telephone_number": "402-475-5161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 N 16th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681024101",
            "country_code": "US",
            "telephone_number": "402-870-0570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORACKE",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1434",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.