Shane Crockett

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

834 Issued in NE

Legal business name

SHANE CROCKETT

Practice address

8101 O St
Suite 118
Lincoln, NE 68510-2646

Phone

(402) 484-0444

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Shane Maynard Crockett, LIMHP

Title

Mental Health Therapist

Phone

(402) 484-0444

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Shane Crockett2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shane Crockett

  • Community/Behavioral Health Agency
  • Lincoln, NE
  • NPI 1396018198
  NPD tax ID

Locations

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1518239797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 O ST",
            "address_2": "SUITE 118",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102646",
            "telephone_number": "402-484-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 O ST",
            "address_2": "SUITE 118",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102646",
            "telephone_number": "402-484-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE CROCKETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "MAYNARD",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "402-484-0444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LIMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025109200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Sue Shamburg, LMHP
• Baseh Shamo
• Greta A Shanahan, LMHP, CPC
• Matthew J. Shanahan, M.S.
• Shane Crockett
• Alyssah M Shane
• Christine Ann Shank, NP-C
• Janice Robin Shannon
• Shiona Shakir Shannon
• Sarah Shareef

• Mental Health Counselor in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.