Individual provider Active NPI

Amelia Den Hartog, LIMHP, LPC, CDGC

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1205197472
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2898 Issued in NE
Practice address
12035 Q St
Omaha, NE 68137
Phone
(402) 991-0611
Fax
(402) 991-6228
NPI assigned
Jun 5, 2012
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2371 NE
Mental Health Counselor 101YM0800X 2898 NE Primary

Addresses

Primary practice location

12035 Q St
Omaha, NE 68137

Mailing address

12035 Q St
Omaha, NE 68137-3542
Phone (402) 991-0611

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
I20240118003783 NE Practitioner - Mental Health Counselor 7315399979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spence Counseling Center PCGroup PAC ID 6204976525, 14 clinicians

Practice addresses (Care Compare)

12035 Q St
Omaha, NE 68137-3542
Phone (402) 991-0611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2898NEMDSocial Worker
2371NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spence Counseling Center PC Mental Health CurrentSince Jan 2, 2024 Accepting new patients

Locations

12035 Q St
Omaha, NE 68137
Phone (402) 704-7814

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, 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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1205197472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12035 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373542",
            "telephone_number": "402-991-0611",
            "fax_number": "402-991-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12035 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68137",
            "telephone_number": "402-991-0611",
            "fax_number": "402-991-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEN HARTOG",
        "first_name": "AMELIA",
        "name_prefix": "Mrs.",
        "credential": "LIMHP, LPC, CDGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2371",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.