Individual provider Active NPI

Hailey Marissa Pierce

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1497407597
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12869 Issued in NE
Practice address
11218 John Galt Blvd Ste 204
Omaha, NE 68137-2358
Phone
(402) 506-9254
Fax
(620) 820-7643
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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 12869 NE Primary

Addresses

Primary practice location

11218 John Galt Blvd Ste 204
Omaha, NE 68137-2358

Mailing address

11218 John Galt Blvd Ste 204
Omaha, NE 68137-2358
Phone (402) 506-9254

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
I20260615002747 NE Practitioner - Mental Health Counselor 2163994740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

516 E
6TH
Valparaiso, NE 68065-0326

5539 S 27TH St
Suite 206
Lincoln, NE 68512-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12869NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Edc of Denver, LLC CurrentSince Jan 26, 2022 Accepting new patients
Edc of Denver, LLC PastSince Jan 26, 2022 Accepting new patients

Locations

11218 John Galt Blvd
Ste 204
Omaha, NE 68137
Phone (402) 353-8080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1497407597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11218 JOHN GALT BLVD STE 204",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372358",
            "telephone_number": "402-506-9254",
            "fax_number": "620-820-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11218 JOHN GALT BLVD STE 204",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372358",
            "telephone_number": "402-506-9254",
            "fax_number": "620-820-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "HAILEY",
        "middle_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.