Individual provider Active NPI

Bahar Bozorgzadeh, PLMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1447012331
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13767 Issued in NE
Practice address
13917 Gold Cir
Omaha, NE 68144-2359
Phone
(402) 991-9630
NPI assigned
Jan 25, 2024
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13767 NE Primary

Addresses

Primary practice location

13917 Gold Cir
Omaha, NE 68144-2359

Mailing address

18109 Trailridge Rd
Omaha, NE 68135-1739
Phone (413) 348-5111

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
I20240320002644 NE Practitioner - Mental Health Counselor 3274970736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ven Whole Healthcare LLCGroup PAC ID 9234521980, 6 clinicians

Practice addresses (Care Compare)

13917 Gold Cir
Omaha, NE 68144-2359
Phone (402) 991-9630

7655 Archer PL
Lincoln, NE 68516-5286
Phone (402) 413-9770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Insomnia and Psychiatric Services, LLC Mental Health CurrentSince Feb 14, 2024 Accepting new patients
Ven Whole Healthcare LLC CurrentSince Feb 21, 2024 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince Feb 14, 2024 Accepting new patients

Locations

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1447012331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18109 TRAILRIDGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351739",
            "telephone_number": "413-348-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13917 GOLD CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442359",
            "telephone_number": "402-991-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZORGZADEH",
        "first_name": "BAHAR",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "13767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.