Individual provider Active NPI

Whitney Lynn Strong-Bak, PHD

  • Psychologist
  • Omaha, NE
National Provider Identifier
1194182204
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
990 Issued in NE
Practice address
6902 Pine St
Omaha, NE 68106-2855
Phone
(402) 559-6408
Fax
(402) 559-5737
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 990 NE Primary

Addresses

Primary practice location

6902 Pine St
Omaha, NE 68106-2855

Mailing address

985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (402) 559-6408

Other identifiers 1

IdentifierTypeStateIssuer
1194182204MedicaidNE

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
I20190917000478 NE Practitioner - Clinical Psychologist 1254660285 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
990NEMDCounselor

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1194182204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902 PINE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062855",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRONG-BAK",
        "first_name": "WHITNEY",
        "middle_name": "LYNN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194182204",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.