Organization Active NPI

Well and Wonders Counseling, LLC

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1720655392
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELL AND WONDERS COUNSELING, LLC
Practice address
301 S 70TH St Ste 350
Lincoln, NE 68510-2472
Phone
(402) 302-1126
NPI assigned
Jun 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Mrs. Erin Jane Polacek, MSED, LIMHP, CPCNPI 1679017214
Title
Mental Health Therapist
Phone
(402) 302-1126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

301 S 70TH St Ste 350
Lincoln, NE 68510-2472

Mailing address

301 S 70TH St Ste 350
Lincoln, NE 68510-2472
Phone (402) 302-1126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241021000208 NE Part B Supplier - Clinic/Group Practice 6608308218 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1720655392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 70TH ST STE 350",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102472",
            "telephone_number": "402-302-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 70TH ST STE 350",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102472",
            "telephone_number": "402-302-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL AND WONDERS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "POLACEK",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "402-302-1126",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSED, LIMHP, CPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.