Individual provider Active NPI

Shawn Devries, PLMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1235455114
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8927 Issued in NE
Practice address
4732 S 131St St
Omaha, NE 68137-1822
Phone
(402) 697-3923
Fax
(402) 697-3924
NPI assigned
Apr 16, 2010
Last updated
Apr 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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 8927 NE Primary

Addresses

Primary practice location

4732 S 131St St
Omaha, NE 68137-1822

Mailing address

4732 S 131St St
Omaha, NE 68137-1822
Phone (402) 697-3923

Other identifiers 1

IdentifierTypeStateIssuer
47082303526MedicaidNE

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
I20231228001002 NE Practitioner - Mental Health Counselor 0941650279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Resource Associates IncGroup PAC ID 8729971049, 8 clinicians

Practice addresses (Care Compare)

10824 Old Mill Rd
Suite 21
Omaha, NE 68154-2642
Phone (402) 330-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3046NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Resource Associates, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Beneficial Behavioral Health Services Past Accepting new patients
Beneficial Behavioral Health Past Accepting new patients

Locations

10824 Old Mill Rd
Ste 21
Omaha, NE 68154
Phone (402) 330-6060

Organizations & group practices 3

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1235455114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 S 131ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371822",
            "telephone_number": "402-697-3923",
            "fax_number": "402-697-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 S 131ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371822",
            "telephone_number": "402-697-3923",
            "fax_number": "402-697-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "SHAWN",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "8927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47082303526",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.