NPIMap

Individual provider Active NPI

Charlene Wilson, LIMHP

  • Professional Counselor
  • Omaha, NE
National Provider Identifier
1215094974
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
960 Issued in NE
Practice address
105 N 31St Ave Ste 212
Omaha, NE 68131-2915
Phone
(402) 378-8508
Fax
(402) 939-0676
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 1921 NE
Professional Counselor 101YP2500X 3878 NE
Professional Counselor 101YP2500X 960 NE Primary

Addresses

Primary practice location

105 N 31St Ave Ste 212
Omaha, NE 68131-2915

Mailing address

105 N 31St Ave Ste 212
Omaha, NE 68131-2915
Phone (402) 378-8508

Other identifiers 2

IdentifierTypeStateIssuer
1921OtherNEPROFESSIONAL COUNSELOR
960OtherNELICENSE INDEPENDENT MENTAL HEALTH PRACTITIONER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3878NEMDProfessional Counselor
1921NEMDPediatrics Physician
960NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Precious Community Services LLC Mental Health CurrentSince Jan 21, 2022 Accepting new patients
Precious Care Counseling, Inc. Mental Health Past Accepting new patients

Locations

105 N 31st Ave
Ste 212
Omaha, NE 68131
Phone (402) 214-6949

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1215094974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N 31ST AVE STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312915",
            "telephone_number": "402-378-8508",
            "fax_number": "402-939-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N 31ST AVE STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312915",
            "telephone_number": "402-378-8508",
            "fax_number": "402-939-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1921",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "3878",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL COUNSELOR",
            "identifier": "1921",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE INDEPENDENT MENTAL HEALTH PRACTITIONER",
            "identifier": "960",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.