NPIMap

Organization Active NPI

Mary P Haskins LLC

  • Clinical Social Worker
  • Fremont, NE
National Provider Identifier
1184055568
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1369 Issued in NE
Legal business name
MARY P HASKINS LLC
Practice address
1627 E Military Ave
Suite 200
Fremont, NE 68025-5490
Phone
(402) 727-4886
Fax
(402) 727-4146
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Mary P Haskins, LCSW, LMHP, LADC
Title
Owner
Phone
(402) 727-4886

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 855 NE
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 3724 NE
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 1369 NE Primary

Addresses

Primary practice location

1627 E Military Ave
Suite 200
Fremont, NE 68025-5490

Mailing address

1627 E Military Ave
Suite 200
Fremont, NE 68025-5490
Phone (402) 727-4886

Other identifiers 2

IdentifierTypeStateIssuer
10025687100MedicaidNE
NA1687OtherMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Mary P Haskins LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1184055568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 E MILITARY AVE",
            "address_2": "SUITE 200",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255490",
            "telephone_number": "402-727-4886",
            "fax_number": "402-727-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E MILITARY AVE",
            "address_2": "SUITE 200",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255490",
            "telephone_number": "402-727-4886",
            "fax_number": "402-727-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY P HASKINS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "HASKINS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-727-4886",
        "authorized_official_credential": "LCSW, LMHP, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "855",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3724",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025687100",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NA1687",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.