Active NPI
Jesse Thomas Jung Glackin, PLMHP
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1669199170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13196
- Practice address
- 5705 W Dodge Rd Suite 102
Omaha, NE 68134-6811 - Phone
- (402) 575-5577
- NPI assigned
- Oct 25, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13196 | NE | Primary |
Addresses
Primary practice location
5705 W Dodge Rd Suite 102
Omaha, NE 68134-6811
Mailing address
1961 Parkwild Dr Apt 127
Council Bluffs, IA 51503-1888
Phone (712) 346-8213
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 |
|---|---|---|---|
| 13196 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jesse Glackin Counseling LLC | Current | 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.
-
- Adult Mental Health Clinic/Center
- Lincoln, NE
- NPI 1790597383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1669199170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1961 PARKWILD DR APT 127",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031888",
"telephone_number": "712-346-8213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5705 W DODGE RD SUITE 102",
"city": "OMAHA",
"state": "NE",
"postal_code": "681346811",
"telephone_number": "402-575-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLACKIN",
"first_name": "JESSE",
"middle_name": "THOMAS JUNG",
"credential": "PLMHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-25",
"last_updated": "2022-10-25",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "13196",
"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 25, 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.