Individual provider Active NPI

Jessica Renee Snyder, PCSW

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1235611468
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3472 Issued in NE
Practice address
2202 S 11TH St
Lincoln, NE 68502-3559
Phone
(402) 475-5161
Fax
(402) 799-1055
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PCSW-810 WY
Clinical Social Worker 1041C0700X 2293 NE
Mental Health Counselor 101YM0800X 3472 NE Primary

Addresses

Primary practice location

2202 S 11TH St
Lincoln, NE 68502-3559

Mailing address

1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-2846

Other practice location 1

1841 Madora Ave
Douglas, WY 82633
Phone (307) 358-2846

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
I20240301002200 NE Practitioner - Mental Health Counselor 3779945910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerpointe IncGroup PAC ID 8123063237, 11 clinicians

Practice addresses (Care Compare)

2202 S 11TH St
Lincoln, NE 68502-3559
Phone (402) 475-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3472NEMDMental Health Counselor
PCSW-810WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centerpointe, Inc. Mental Health CurrentSince Jan 10, 2024 Accepting new patients

Locations

2633 P St
Lincoln, NE 68503
Phone (402) 475-5161

2202 S 11th St
Lincoln, NE 68502
Phone (402) 475-5161

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1235611468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 MADORA AVE",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826333057",
            "telephone_number": "307-358-2846",
            "fax_number": "307-358-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S 11TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023559",
            "telephone_number": "402-475-5161",
            "fax_number": "402-799-1055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 Madora Ave",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "WY",
            "postal_code": "82633",
            "country_code": "US",
            "telephone_number": "307-358-2846",
            "fax_number": "307-358-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "PCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "PCSW-810",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2293",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.