Individual provider Active NPI

Lori L Mimick, LIMHP, LPC, LADC

  • Professional Counselor
  • Lincoln, NE
National Provider Identifier
1407097033
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1909 Issued in NE
Practice address
301 S 70TH St
Ste 319
Lincoln, NE 68510-2469
Phone
(402) 937-0426
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 891 NE
Mental Health Counselor 101YM0800X 1369 NE
Mental Health Counselor 101YM0800X 3849 NE
Professional Counselor 101YP2500X 1909 NE Primary

Addresses

Primary practice location

301 S 70TH St
Ste 319
Lincoln, NE 68510-2469

Mailing address

301 S 70TH St
Ste 319
Lincoln, NE 68510-2469
Phone (402) 937-0426

Other practice location 1

8221 Beechwood Dr
Lincoln, NE 68510-2617
Phone (402) 890-7873

Other names 1

  • Lori L Mimick-Carde Former name

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
I20240606000883 NE Practitioner - Mental Health Counselor 1951843903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3849NEMDMental Health Counselor
1909NEMDClinical Social Worker
891NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
M&M Counseling Addiction (Substance Use Disorder) CurrentSince Jul 7, 2024 Accepting new patients
Blue Valley Behavioral Health Inc PastSince Jan 1, 2021 Accepting new patients
The Insight Program, P.C. Mental Health PastSince Oct 1, 2021 Accepting new patients
Life Resources, LLC PastSince Oct 1, 2021 Accepting new patients

Locations

301 S 70th St
Ste 319
Lincoln, NE 68510
Phone (402) 937-0426

Organizations & group practices 4

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": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1407097033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 70TH ST",
            "address_2": "STE 319",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102469",
            "telephone_number": "402-937-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 70TH ST",
            "address_2": "STE 319",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102469",
            "telephone_number": "402-937-0426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8221 Beechwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685102617",
            "country_code": "US",
            "telephone_number": "402-890-7873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMICK",
        "first_name": "LORI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LIMHP, LPC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "891",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1369",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3849",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "MIMICK-CARDE",
            "middle_name": "L",
            "credential": "LIMHP, LPC, LADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.