Individual provider Active NPI

Brooke Elizabeth Bartak-Jensen, LIMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1245505775
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9617 Issued in NE
Practice address
10020 Nicholas St Ste 106
Omaha, NE 68114-2188
Phone
(402) 957-2759
NPI assigned
Mar 16, 2012
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 9617 NE Primary

Addresses

Primary practice location

10020 Nicholas St Ste 106
Omaha, NE 68114-2188

Mailing address

10020 Nicholas St Ste 106
Omaha, NE 68114-2188
Phone (402) 957-2759

Other identifiers 1

IdentifierTypeStateIssuer
470398819MedicaidNE

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
9617NEMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1245505775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 NICHOLAS ST STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142188",
            "telephone_number": "402-957-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 NICHOLAS ST STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142188",
            "telephone_number": "402-957-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTAK-JENSEN",
        "first_name": "BROOKE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470398819",
            "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 Mar 15, 2021; 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.