Active NPI
Theresa Kay Koehler, PLADC
- Addiction (Substance Use Disorder) Counselor
- Omaha, NE
National Provider Identifier
1659032068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- P-1629
- Practice address
- 11215 John Galt Blvd
Omaha, NE 68137-2319 - Phone
- (402) 592-5900
- Fax
- (402) 592-5901
- NPI assigned
- Jan 7, 2022
- Last updated
- Jan 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | P-1629 | NE | Primary |
Addresses
Primary practice location
11215 John Galt Blvd
Omaha, NE 68137-2319
Mailing address
11215 John Galt Blvd
Omaha, NE 68137-2319
Phone (402) 592-5900
Other names 1
- Theresa Kay Schwock
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | omaha@methadonetreatmentcenter.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| P-1629 | NE | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omaha Treatment Center, LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1659032068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11215 JOHN GALT BLVD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372319",
"telephone_number": "402-592-5900",
"fax_number": "402-592-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11215 JOHN GALT BLVD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372319",
"telephone_number": "402-592-5900",
"fax_number": "402-592-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHLER",
"first_name": "THERESA",
"middle_name": "KAY",
"credential": "PLADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "P-1629",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "omaha@methadonetreatmentcenter.com",
"affiliation": "N",
"endpointDescription": "omaha@methadonetreatmentcenter.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "11215 John Galt Blvd",
"city": "Omaha",
"state": "NE",
"country_code": "US",
"postal_code": "681372319",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "THERESA",
"last_name": "SCHWOCK",
"middle_name": "KAY",
"code": "5",
"type": "Other Name"
}
]
}
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 Jan 7, 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.