Individual provider Active NPI

Jill Diane Eckerman, MS

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1457656829
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
846 Issued in NE
Practice address
11909 Arbor St Ste a
Omaha, NE 68144-4418
Phone
(402) 708-7597
Fax
(402) 625-0455
NPI assigned
Jan 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 520 NE
Mental Health Counselor 101YM0800X 846 NE Primary

Addresses

Primary practice location

11909 Arbor St Ste a
Omaha, NE 68144-4418

Mailing address

15733 Jackson Dr
Omaha, NE 68118-2105
Phone (402) 657-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
846NEMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Zen Integrative Counseling & Recovery LLC Addiction (Substance Use Disorder) CurrentSince Aug 2, 2020 Accepting new patients

Locations

11909 Arbor St
Ste A
Omaha, NE 68144
Phone (402) 304-0760

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": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1457656829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15733 JACKSON DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182105",
            "telephone_number": "402-657-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 ARBOR ST STE A",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444418",
            "telephone_number": "402-708-7597",
            "fax_number": "402-625-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERMAN",
        "first_name": "JILL",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.