Medjine Desgraves, PLMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3061 Issued in NE

Practice address

5217 S 28TH St
Omaha, NE 68107-3402

Phone

(402) 715-5449

Fax

(402) 715-5452

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

True Vine Counseling LLCGroup PAC ID 7719464684, 2 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.

• True Vine Counseling LLC

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1881463586
  Medicare reassignment Care Compare group NPD
• House Enterprises Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Papillion, NE
  • NPI 1285929844
  NPD (past)
• House Enterprises Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Omaha, NE
  • NPI 1568996981
  NPD (past)
• Stephen Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Omaha, NE
  • NPI 1205135001
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1285250332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 S 28TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681073402",
            "telephone_number": "402-715-5449",
            "fax_number": "402-715-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 S 28TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681073402",
            "telephone_number": "402-715-5449",
            "fax_number": "402-715-5452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 S 42nd St Ste 328",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681052943",
            "country_code": "US",
            "telephone_number": "402-614-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESGRAVES",
        "first_name": "MEDJINE",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "12187",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promise Deschaine
• Ashley Renee Deschamp, M.D.
• Sarah Marie Deselms
• Desert Bloom Therapy, LLC
• Ann-Marsha Veruka Desgraves
• Angela Ann Deshane
• Tanya Kay Deshazo
• Pooja A Deshmukh, M.D
• Sonali S Deshmukh, MD
• Heather Desilet

• 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 May 31, 2024; 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.