Active NPI
Stephane Hethienn
- Counselor
- Omaha, NE
National Provider Identifier
1427850346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 5894
- Practice address
- 11209 King St
Omaha, NE 68142-1825 - Phone
- (402) 505-1676
- NPI assigned
- Mar 24, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | 1234 | ||
| School Psychologist | 103TS0200X | 987456A | ||
| Counselor | 101Y00000X | 5894 | LA | Primary |
Addresses
Primary practice location
11209 King St
Omaha, NE 68142-1825
Mailing address
11209 King St
Omaha, NE 68142-1825
Phone (402) 505-1676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5894 | LA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742774400000",
"number": "1427850346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11209 KING ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681421825",
"telephone_number": "402-505-1676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11209 KING ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681421825",
"telephone_number": "402-505-1676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETHIENN",
"first_name": "STEPHANE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-24",
"last_updated": "2025-03-24",
"certification_date": "2025-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": "1234",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": "987456A",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "LA",
"license": "5894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.