Individual provider Active NPI

Tiffany M Minturn

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1184126021
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3321 Tucker St
Omaha, NE 68112-1711
Phone
(402) 315-8964
NPI assigned
Mar 7, 2018
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 NE Primary

Addresses

Primary practice location

3321 Tucker St
Omaha, NE 68112-1711

Mailing address

3321 Tucker St
Omaha, NE 68112-1711
Phone (402) 315-8964

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
I20240404001637 NE Practitioner - Mental Health Counselor 1759729163 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11235 Davenport St
Suite 106
Omaha, NE 68154-2690
Phone (402) 315-8964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1504NEMDPhysical Therapist
3239NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Nebraska CurrentSince Mar 11, 2024 Accepting new patients
Lighted Paths Counseling LLC CurrentSince Mar 14, 2024 Accepting new patients
Douglas County Nebraska CurrentSince Mar 11, 2024 Accepting new patients
Growth & Grace Counseling LLC Mental Health CurrentSince Mar 5, 2024 Accepting new patients
Beneficial Behavioral Health Services, Inc. Past Accepting new patients

Locations

142 W Marengo St
Albion, NE 68620
Phone (402) 396-5710

11235 Davenport St
Ste 106
Omaha, NE 68154
Phone (402) 315-8964

4102 Woolworth Ave
Omaha, NE 68105
Phone (402) 444-7000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1184126021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 TUCKER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121711",
            "telephone_number": "402-315-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 TUCKER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121711",
            "telephone_number": "402-315-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTURN",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.