Individual provider Active NPI

Kalika Brekan Jantzen, LIMHP, LADC

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1255527362
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
895 Issued in NE
Practice address
300 S 68TH Street PL
Suite 500
Lincoln, NE 68510-2475
Phone
(402) 434-2730
Fax
(402) 434-3970
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 895 NE Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 713 NE

Addresses

Primary practice location

300 S 68TH Street PL
Suite 500
Lincoln, NE 68510-2475

Mailing address

300 S 68TH Street PL
Suite 500
Lincoln, NE 68510-2475
Phone (402) 434-2730

Other identifiers 5

IdentifierTypeStateIssuer
10025734000MedicaidNE
10026038300MedicaidNE
345680000OtherNEMAGELLAN MIS
47075636930MedicaidNE
47075636998MedicaidNE

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
895NEMDClinical Social Worker
713NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
First Step Recovery Center Inc. Addiction (Substance Use Disorder) PastSince Oct 1, 1999 Accepting new patients

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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1255527362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 68TH STREET PL",
            "address_2": "SUITE 500",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102475",
            "telephone_number": "402-434-2730",
            "fax_number": "402-434-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 68TH STREET PL",
            "address_2": "SUITE 500",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102475",
            "telephone_number": "402-434-2730",
            "fax_number": "402-434-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANTZEN",
        "first_name": "KALIKA",
        "middle_name": "BREKAN",
        "name_prefix": "Mrs.",
        "credential": "LIMHP, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "895",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025734000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026038300",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS",
            "identifier": "345680000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47075636930",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47075636998",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.