Grand Island Mental Health LLC
Organization Active NPI Mental Health Counselor · Grand Island, NE
NPI 1306289194 · NPPES record last updated Dec 14, 2020
Key facts
- NPI
- 1306289194
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- GRAND ISLAND MENTAL HEALTH LLC
- Practice address
- 1917 W Faidley Ave
Grand Island, NE 68803-4642 - Phone
- (308) 398-0350
- Fax
- (308) 398-0351
- NPI assigned
- Apr 10, 2013
- Organization subpart
- No
Authorized official
- Name
- Ms. Debra K Erickson
- Title
- Owner
- Phone
- (308) 398-0350
Practitioners 16
-
Jordan Marie Hofmann, MA, PLMHP
-
Janet R. Jurgensen Duba NP, A.P.R.N. N.P.
-
Ashley L Schwieger, LIMHP
-
Tina Williams, LIMHP, LMHP, LPC
-
Celianne Marie Bacon, PMHNP-BC
-
Cindy Ann Betka, LADC
-
Jennifer L Chavez, APRN
-
Lorie Ann Escobar, M.A., L.M.H.P
-
Cheryl Lyn Lockett, APRN
-
Kylene Marie Schroer, APRN
-
Alexis Bloomfield, PLMHP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201231000387 | NE | Part B Supplier - Clinic/Group Practice | 1153734629 |
Receives reassigned benefits from 16 practitioners Practice locations: Grand Island, NE |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes |
Addresses
Primary practice location
1917 W Faidley Ave
Grand Island, NE 68803-4642
Mailing address
1917 W Faidley Ave
Grand Island, NE 68803-4642
Phone (308) 398-0350
Other providers in Grand Island, NE
- Grand Island Health Care Inc
- Grand Island Hearing Aid Center, Inc.
- Grand Island Imaging Center LLC
- Grand Island Lakeview Care and Rehabilitation Center, LLC
- Grand Island Lakeview Operations LLC
- Grand Island Opco LLC
- Grand Island Optical PC
- Grand Island Pain Relief Center PC
- Grand Island Park Operations LLC
- Grand Island Park Place Care and Rehabilitation Center, LLC
All providers in Grand Island, NE · Mental Health Counselor in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.