Active NPI
Jonnae Luck, LIMHP, LCSW, LADC
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1720445208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4911 Grand Ave
Omaha, NE 68104-2380 - Phone
- (562) 746-5150
- Fax
- (402) 551-8797
- NPI assigned
- Jan 28, 2016
- Last updated
- Jan 24, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10719 | ND | |
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
4911 Grand Ave
Omaha, NE 68104-2380
Mailing address
3300 N 60TH St
Omaha, NE 68104-3402
Phone (402) 554-0520
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025225100 | Medicaid | NE | |
| 47037661200 | Medicaid | NE |
Other names 1
- Jonnae Reams
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10719 | ND | MD | Mental Health Counselor |
| 1824 | NE | MD | Psychiatry Physician |
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Omaha, NE
- NPI 1295487916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1720445208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 N 60TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681043402",
"telephone_number": "402-554-0520",
"fax_number": "402-551-8797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4911 GRAND AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681042380",
"telephone_number": "562-746-5150",
"fax_number": "402-551-8797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCK",
"first_name": "JONNAE",
"credential": "LIMHP, LCSW, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-28",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ND",
"license": "10719",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025225100",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47037661200",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JONNAE",
"last_name": "REAMS",
"code": "1",
"type": "Former 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 24, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.