Individual provider Active NPI

Emily R Loethen

  • Psychologist
  • Omaha, NE
National Provider Identifier
1376113589
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1152 Issued in NE
Practice address
6902 Pine St
Omaha, NE 68106-2855
Phone
(402) 559-6408
Fax
(402) 559-5737
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1152 NE Primary
Mental Health Counselor 101YM0800X 12961 NE
Behavior Technician 106S00000X OK

Addresses

Primary practice location

6902 Pine St
Omaha, NE 68106-2855

Mailing address

6902 Pine St
Omaha, NE 68106-2855

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
I20241121002759 NE Practitioner - Clinical Psychologist 2466987839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12961NEMDPharmacist
1152NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents CurrentSince Oct 10, 2024 Accepting new patients
University of Nebraska Board of Regents CurrentSince Oct 10, 2024 Accepting new patients

Locations

6902 Pine St
Omaha, NE 68106
Phone (402) 559-6418

985450 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-6408

Organizations & group practices 2

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1376113589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6902 PINE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902 PINE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062855",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOETHEN",
        "first_name": "EMILY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "1152",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12961",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.