Individual provider Active NPI

Jeremy T Simonsen, M.S.

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1649406935
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1831 Issued in NE
Practice address
4201 S 14TH St
Lincoln, NE 68502-5336
Phone
(402) 479-3469
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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 1831 NE Primary

Addresses

Primary practice location

4201 S 14TH St
Lincoln, NE 68502-5336

Mailing address

1220 Rose St
Lincoln, NE 68502-2375
Phone (402) 310-2202

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1831NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Nebraska Dept of Admin Services PastSince Jun 9, 2024 Accepting new patients

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1649406935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 ROSE ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685022375",
            "telephone_number": "402-310-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S 14TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685025336",
            "telephone_number": "402-479-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSEN",
        "first_name": "JEREMY",
        "middle_name": "T",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1831",
            "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 Jun 2, 2009; 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.