Individual provider Active NPI

Mary Kathleen Ogle, LCSW, LIMHP, MHP

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1639329477
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
226 Issued in NE
Practice address
1911 Broadmoore Dr
Lincoln, NE 68506-2317
Phone
(402) 486-4754
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 226 NE Primary
Mental Health Counselor 101YM0800X 1553 NE
Clinical Social Worker 1041C0700X 841 NE

Addresses

Primary practice location

1911 Broadmoore Dr
Lincoln, NE 68506-2317

Mailing address

1911 Broadmoore Dr
Lincoln, NE 68506-2317
Phone (402) 486-4754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180716002028 NE Practitioner - Clinical Social Worker 6002163532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

770 N Cotner Blvd
Suite 328
Lincoln, NE 68505-2344
Phone (402) 486-4754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
841NEMDPsychologist
1553NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cognitive Change, LLC CurrentSince May 7, 2018 Accepting new patients

Locations

770 N Cotner Blvd
Ste 328
Lincoln, NE 68505
Phone (402) 286-2754

Organizations & group practices 1

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1639329477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 BROADMOORE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062317",
            "telephone_number": "402-486-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 BROADMOORE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062317",
            "telephone_number": "402-486-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "LCSW, LIMHP, MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "226",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1553",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.