Active NPI
Ellen Katherine Shafer-Lind, LMSW
- Clinical Social Worker
- Kearney, NE
National Provider Identifier
1245409689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 548
- Practice address
- 2222 2ND Ave
Suite 801 Box 8
Kearney, NE 68847-5354 - Phone
- (308) 999-9500
- NPI assigned
- Feb 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1035 | NE | |
| Clinical Social Worker | 1041C0700X | 548 | NE | Primary |
Addresses
Primary practice location
2222 2ND Ave
Suite 801 Box 8
Kearney, NE 68847-5354
Mailing address
2222 2ND Ave
Suite 801 Box 8
Kearney, NE 68847-5354
Phone (308) 999-9500
Other names 1
- Mrs. Ellen Katherine Shafer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3517 | NE | MD | Mental Health Counselor |
| 548 | NE | MD | Registered Dietitian |
| 1035 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Matters Counseling Services LLC | Current | Accepting new patients |
Locations
410 E B St
North Platte, NE 69101
Phone (308) 534-3351
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.
-
- Counselor
- North Platte, NE
- NPI 1639560592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1245409689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 2ND AVE",
"address_2": "SUITE 801 BOX 8",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688475354",
"telephone_number": "308-999-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 2ND AVE",
"address_2": "SUITE 801 BOX 8",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688475354",
"telephone_number": "308-999-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER-LIND",
"first_name": "ELLEN",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "1035",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELLEN",
"last_name": "SHAFER",
"middle_name": "KATHERINE",
"prefix": "MRS.",
"credential": "LMSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.