Active NPI
Cheryl G Willis, APRN
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1508081936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 275416
- Practice address
- 6901 N 72ND St
Omaha, NE 68122-1709 - Phone
- (402) 572-2916
- Fax
- (402) 572-3544
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 275416 | NE | Primary |
Addresses
Primary practice location
6901 N 72ND St
Omaha, NE 68122-1709
Mailing address
PO Box 641130
Omaha, NE 68164-7130
Phone (402) 572-2907
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 275416 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1508081936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 641130",
"city": "OMAHA",
"state": "NE",
"postal_code": "681647130",
"telephone_number": "402-572-2907",
"fax_number": "402-572-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 N 72ND ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681221709",
"telephone_number": "402-572-2916",
"fax_number": "402-572-3544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "CHERYL",
"middle_name": "G",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "275416",
"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 Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.