NPIMap

Organization Active NPI

Wholeness Healing Center, P.C.

  • Mental Health Counselor
  • Broken Bow, NE
National Provider Identifier
1407944838
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WHOLENESS HEALING CENTER, P.C.
Practice address
525 S 9TH Ave
Broken Bow, NE 68822-2457
Phone
(308) 872-5040
Fax
(308) 872-5060
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jane L Watson, LSCWNPI 1770688657
Title
Director, Owner
Phone
(308) 872-5040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

525 S 9TH Ave
Broken Bow, NE 68822-2457

Mailing address

525 S 9TH Ave
Broken Bow, NE 68822-2457
Phone (308) 872-5040

Other identifiers 1

IdentifierTypeStateIssuer
10025173200MedicaidNE

National Provider Directory

National Provider Directory
Tax ID family
Wholeness Healing Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

525 S 9th Ave
Broken Bow, NE 68822
Phone (308) 872-5040

2608 Old Fair Rd
Grand Island, NE 68803
Phone (308) 382-5297

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407944838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S 9TH AVE",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688222457",
            "telephone_number": "308-872-5040",
            "fax_number": "308-872-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 9TH AVE",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688222457",
            "telephone_number": "308-872-5040",
            "fax_number": "308-872-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLENESS HEALING CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, OWNER",
        "authorized_official_telephone_number": "308-872-5040",
        "authorized_official_credential": "LSCW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.