Individual provider Active NPI

Angela M Runquist, MSW, PLMHP

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1316255649
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9060 Issued in NE
Practice address
914 Baumann Dr
Grand Island, NE 68803-4401
Phone
(308) 385-5250
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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 9060 NE Primary
Clinical Social Worker 1041C0700X 6699 NE

Addresses

Primary practice location

914 Baumann Dr
Grand Island, NE 68803-4401

Mailing address

4010 R Ave
Apt a-7
Kearney, NE 68847-2302
Phone (402) 910-1063

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
6699NEMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1316255649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 R AVE",
            "address_2": "APT A-7",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472302",
            "telephone_number": "402-910-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 BAUMANN DR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034401",
            "telephone_number": "308-385-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNQUIST",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "MSW, PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9060",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "6699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.