Jay Dominic Patil, MS, LMHP, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3441 Issued in NE

Practice address

13460 Walsh Dr
Boys Town, NE 68010-7529

Phone

(402) 498-3358

Fax

(402) 498-3375

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1568526788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 N 50TH ST APT 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322245",
            "telephone_number": "402-321-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "402-498-3358",
            "fax_number": "402-498-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "JAY",
        "middle_name": "DOMINIC",
        "credential": "MS, LMHP, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025745300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026139700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura A Novoa, M.D.
• Sadie Ann Claire O'Neill, AUD
• Cynthia L. Page, PHD
• Heather Andrea Page, PLMHP
• Lisa Paradis, LMHP, LADC
• Rosemary J Pauley, APRN
• Melissa Ann Pedersen
• Matthew M Peter, PH.D.
• Abby Marie Peterson, MD
• Maria Jane Pfeffer, LMHP, PLADC

• Mental Health Counselor in Boys Town, NE
• Providers in Boys Town, 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 Oct 2, 2017; 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.