Organization Active NPI

Wiedel Behavioral Health LLC

  • Counselor
  • Lincoln, NE
National Provider Identifier
1598396806
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
WIEDEL BEHAVIORAL HEALTH LLC
Practice address
3801 Union Dr Ste 206
Lincoln, NE 68516-6652
Phone
(402) 489-2218
NPI assigned
Jan 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Ms. Karla Nichole WiedelNPI 1083786271
Title
Behavioral Health Therapist
Phone
(308) 383-5282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

3801 Union Dr Ste 206
Lincoln, NE 68516-6652

Mailing address

3801 Union Dr Ste 206
Lincoln, NE 68516-6652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912000707 NE Part B Supplier - Clinic/Group Practice 5496295883 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1598396806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 UNION DR STE 206",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 UNION DR STE 206",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166652",
            "telephone_number": "402-489-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIEDEL BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "WIEDEL",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "308-383-5282",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.