Individual provider Active NPI

Amanda Dieckgrafe, MS, LIMHP

  • Counselor
  • Lincoln, NE
National Provider Identifier
1366194789
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3742 Issued in NE
Practice address
4545 S 86TH St
Lincoln, NE 68526-9262
Phone
(402) 483-6990
Fax
(402) 483-7045
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3742 NE Primary

Addresses

Primary practice location

4545 S 86TH St
Lincoln, NE 68526-9262

Mailing address

4545 S 86TH St
Lincoln, NE 68526-9262
Phone (402) 483-6990

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231221003491 NE Practitioner - Mental Health Counselor 7911357595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Sun Mental HealthGroup PAC ID 4082885793, 9 clinicians

Practice addresses (Care Compare)

4545 S 86TH St
Lincoln, NE 68526-9262
Phone (402) 483-6990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3742NEMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Sun Mental Health Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

110 N 9th St
Beatrice, NE 68310
Phone (402) 483-6990

4545 S 86th St
Lincoln, NE 68526
Phone (402) 483-6990

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1366194789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269262",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 S 86TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269262",
            "telephone_number": "402-483-6990",
            "fax_number": "402-483-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKGRAFE",
        "first_name": "AMANDA",
        "credential": "MS, LIMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "3742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.