Active NPI
Amy Oberdin
- Mental Health Counselor
- Council Bluffs, IA
National Provider Identifier
1679985808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 072521
- Practice address
- 515 E Broadway
Council Bluffs, IA 51503-4419 - Phone
- (712) 322-1407
- NPI assigned
- May 22, 2014
- Sex
- Female
- 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 | 072521 | IA | Primary |
Addresses
Primary practice location
515 E Broadway
Council Bluffs, IA 51503-4419
Mailing address
423 S 159TH St
Omaha, NE 68118-2140
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 |
|---|---|---|---|
| 072521 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400716800000",
"number": "1679985808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 S 159TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 E BROADWAY",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034419",
"telephone_number": "712-322-1407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERDIN",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-22",
"last_updated": "2014-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "072521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.