Jessica Lynette Petersen, LIMHP, LMHP, CMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2846 Issued in NE

Practice address

11204 Davenport St Ste 200
Omaha, NE 68154-2658

Phone

(402) 356-3332

NPI assigned

Oct 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Behavioral Care of Ohio IncGroup PAC ID 7719325083, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Omaha, NE
  • NPI 1033985726
  Medicare reassignment Care Compare group NPD
• Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Omaha, NE
  • NPI 1134995822
  NPD
• Optum Behavioral Care of Ohio, Inc.

  • Clinical Social Worker
  • Maryland Heights, MO
  • NPI 1528945623
  NPD
• A Better Way Therapy LLC

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1013003623
  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1699555243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 DAVENPORT ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542658",
            "telephone_number": "402-327-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 DAVENPORT ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542658",
            "telephone_number": "402-356-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JESSICA",
        "middle_name": "LYNETTE",
        "credential": "LIMHP, LMHP, CMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2246",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NE",
            "license": "2846",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Petersen
• Brian Douglas Petersen
• Courtney M Petersen
• Cynthia Denise Petersen
• Janell Petersen
• Joan Petersen
• Jocelyn Petersen
• Jodi Lyn Petersen, MS, NCC, LMHP, LPC
• Kerry Lynn Petersen, APRN
• Kirstin Petersen

• Social Worker in Omaha, NE
• Providers in Omaha, NE by specialty
• Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.