NPIMap

Individual provider Active NPI

Jessica M Vandercoy, LMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1588006993
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3948 Issued in NE
Practice address
5605 Northern Hills Dr
Omaha, NE 68152-1192
Phone
(402) 980-1261
Fax
(402) 980-1261
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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 3948 NE Primary

Addresses

Primary practice location

5605 Northern Hills Dr
Omaha, NE 68152-1192

Mailing address

5605 Northern Hills Dr
Omaha, NE 68152-1192
Phone (402) 980-1261

Other practice location 1

124 S 24th St
Ste 230
Omaha, NE 68102-1226
Phone (402) 978-5673

Other identifiers 1

IdentifierTypeStateIssuer
1588006993MedicaidNE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3948NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Lutheran Family Services of NE, Inc Mental Health PastSince Nov 1, 2009 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessicavandercoy@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1588006993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 NORTHERN HILLS DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681521192",
            "telephone_number": "402-980-1261",
            "fax_number": "402-980-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 NORTHERN HILLS DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681521192",
            "telephone_number": "402-980-1261",
            "fax_number": "402-980-1261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 S 24th St",
            "address_2": "Ste 230",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681021226",
            "country_code": "US",
            "telephone_number": "402-978-5673",
            "fax_number": "402-591-5075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERCOY",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "LMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588006993",
            "state": "NE"
        }
    ],
    "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 Mar 2, 2020; 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.