Individual provider Active NPI

Maria Sue Nielsen, MSW, LIMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1407028160
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1454 Issued in NE
Practice address
2126 N 117TH Ave
Omaha, NE 68164-3670
Phone
(402) 934-1617
Fax
(402) 934-5228
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1396 NE
Mental Health Counselor 101YM0800X 1454 NE Primary

Addresses

Primary practice location

2126 N 117TH Ave
Omaha, NE 68164-3670

Mailing address

2126 N 117TH Ave
Omaha, NE 68164-3670
Phone (402) 934-1617

Other identifiers 1

IdentifierTypeStateIssuer
10025339600MedicaidNE

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL omahaic.com Direct
CONNECT URL omahaic.com

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
I20200130001821 NE Practitioner - Clinical Social Worker 7911333562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Integrative Care, LLCGroup PAC ID 4183875776, 15 clinicians

Practice addresses (Care Compare)

2126 N 117TH Ave
Omaha, NE 68164-3670
Phone (402) 934-1617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1396NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Integrative Care, LLC Clinical CurrentSince Mar 31, 2024 Accepting new patients

Locations

2126 N 117th Ave
Omaha, NE 68164
Phone (402) 934-1617

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8127/brand/1/csg/1/fhir/r4

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1407028160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-934-1617",
            "fax_number": "402-934-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 117TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643670",
            "telephone_number": "402-934-1617",
            "fax_number": "402-934-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "MARIA",
        "middle_name": "SUE",
        "credential": "MSW, LIMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1396",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025339600",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "omahaic.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2126 N 117th Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681643670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "omahaic.com",
            "affiliation": "N",
            "address_1": "2126 N 117th Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681643670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.