Jacqueline Anne Anderson, ED.S, LMHP, LPC,

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

31858 Issued in NE

Practice address

408 10TH St
Gothenburg, NE 69138-1922

Phone

(308) 529-0821

NPI assigned

Jan 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1346397338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 99",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691389607",
            "telephone_number": "308-537-2585",
            "fax_number": "308-537-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 10TH ST",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381922",
            "telephone_number": "308-529-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "ED.S, LMHP, LPC,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2756",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1465",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NE",
            "license": "31858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025003500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Aden, DDS
• Agape Medical Staffing
• Rosa Linda Banda Alvidrez
• Autumn Ambler, MS, CCC-SLP
• Joanne Kay Atkinson
• Craig David Bartruff, M.D.
• Betty L Johnson
• Terese Ann Bevard
• Mary Lou Block, RDN LMNT

• All providers in Gothenburg, NE
• School Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.