NPIMap

Organization Active NPI

Brookstone Counseling and Wellness

  • Mental Health Counselor
  • Norfolk, NE
National Provider Identifier
1366840738
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4115 Issued in NE
Legal business name
BROOKSTONE COUNSELING AND WELLNESS
Practice address
1013 North 13 Street
Suite 4
Norfolk, NE 68701-2592
Phone
(402) 369-6052
NPI assigned
Dec 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Dr. Branislava Knezevic, LMHP
Title
Counselor
Phone
(402) 404-0175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 4115 NE Primary

Addresses

Primary practice location

1013 North 13 Street
Suite 4
Norfolk, NE 68701-2592

Mailing address

1013 N. 13TH Street
Suite 4
Norfolk, NE 68701-2592
Phone (402) 369-6052

Other identifiers 1

IdentifierTypeStateIssuer
10026415300MedicaidNE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1366840738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 N. 13TH STREET",
            "address_2": "SUITE 4",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012592",
            "telephone_number": "402-369-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 NORTH 13 STREET",
            "address_2": "SUITE 4",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012592",
            "telephone_number": "402-369-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSTONE COUNSELING AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "KNEZEVIC",
        "authorized_official_first_name": "BRANISLAVA",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "402-404-0175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026415300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.