Individual provider Active NPI

Ryan John Mahnke, MS, PLMHP

  • Professional Counselor
  • Fremont, NE
National Provider Identifier
1669928602
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12706 Issued in NE
Practice address
230 E 22ND St
Fremont, NE 68025-2661
Phone
(402) 214-9254
Fax
(402) 727-4288
NPI assigned
Aug 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10965 NE
Professional Counselor 101YP2500X 12706 NE Primary

Addresses

Primary practice location

230 E 22ND St
Fremont, NE 68025-2661

Mailing address

4102 Woolworth Ave
Omaha, NE 68105-1851
Phone (402) 444-7608

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
10965NEMDProfessional Counselor
12706NEMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1669928602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051851",
            "telephone_number": "402-444-7608",
            "fax_number": "402-996-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 22ND ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252661",
            "telephone_number": "402-214-9254",
            "fax_number": "402-727-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKE",
        "first_name": "RYAN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MS, PLMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "10965",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "12706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.