Jillian Kay Booth

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

10845 Harney St
Omaha, NE 68154-2639

Phone

(402) 327-1197

NPI assigned

Jan 16, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citycare Counseling IncGroup PAC ID 4486148665, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Citycare Counseling, Inc

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1174927198
  Medicare reassignment Care Compare group NPD
• Centered Mindfulness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Omaha, NE
  • NPI 1760306518
  NPD (past) Authorized official

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1265147185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 S 152ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445123",
            "telephone_number": "402-650-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10845 HARNEY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542639",
            "telephone_number": "402-327-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JILLIAN",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bronson Boosalis, M.D.
• Kaitlyn Ann Boosalis, MPAS, PA-C
• Taylor Boosalis
• Christopher Booth
• Demond'Trell Booth
• Kimberly L Booth
• Mark Booth
• Rachassa Booth
• Shallona Untrea Booth
• Amanda N Boothe, PLMHP

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.