Individual provider Active NPI

Angela D Clarken, LIMHP MSW

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1205511136
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3225 Issued in NE
Practice address
7101 Newport Ave
Omaha, NE 68152-2164
Phone
(402) 572-2916
Fax
(402) 572-2528
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 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 3225 NE Primary

Addresses

Primary practice location

7101 Newport Ave
Omaha, NE 68152-2164

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6248

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
I20230714000844 NE Practitioner - Clinical Social Worker 7113387747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

7101 Newport Ave
Omaha, NE 68152-2164
Phone (402) 572-2905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2215NEMDMental Health Counselor
3225NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health CurrentSince Jul 1, 2023 Accepting new patients
Alegent Creighton Health CurrentSince Jul 1, 2023 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 2

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1205511136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6248",
            "fax_number": "402-572-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NEWPORT AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681522164",
            "telephone_number": "402-572-2916",
            "fax_number": "402-572-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKEN",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "LIMHP MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.