Individual provider Active NPI

Mickey Lynn Skelton

  • Addiction (Substance Use Disorder) Counselor
  • Omaha, NE
National Provider Identifier
1629642202
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
P-1843 Issued in NE
Practice address
2823 N 81St St
Omaha, NE 68134-6411
Phone
(402) 609-2778
NPI assigned
May 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X P-1843 NE Primary

Addresses

Primary practice location

2823 N 81St St
Omaha, NE 68134-6411

Mailing address

2823 N 81St St
Omaha, NE 68134-6411
Phone (402) 609-2778

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
P-1843NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Accomplished Recovery and Counseling LLC Addiction (Substance Use Disorder) Current Accepting new patients
Cultivating Paths Counseling Addiction (Substance Use Disorder) PastSince May 9, 2021 Accepting new patients

Locations

2823 N 81st St
Omaha, NE 68134
Phone (402) 392-0907

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": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1629642202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 N 81ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346411",
            "telephone_number": "402-609-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 N 81ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346411",
            "telephone_number": "402-609-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "MICKEY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-1843",
            "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 4, 2022; 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.