Active NPI
Jacqueline Gray Okun, LADAC, LIMHP, LCSW
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1730239161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 909
- Practice address
- 11125 Woolworth PLZ
Omaha, NE 68144-1882 - Phone
- (402) 553-8769
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6352 | NE | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 541 | NE | |
| Clinical Social Worker | 1041C0700X | 3316 | NE | |
| Mental Health Counselor | 101YM0800X | 909 | NE | Primary |
Addresses
Primary practice location
11125 Woolworth PLZ
Omaha, NE 68144-1882
Mailing address
11125 Woolworth Plaza
Omaha, NE 68144
Phone (402) 553-8769
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 773433000 | Other | NE | MAGELLAN |
| 10025359000 | Medicaid | NE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3316 | NE | MD | Clinical Social Worker |
| 6352 | NE | MD | Clinical Social Worker |
| 909 | NE | MD | Physical Therapy Assistant |
| 541 | NE | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1730239161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11125 WOOLWORTH PLAZA",
"city": "OMAHA",
"state": "NE",
"postal_code": "68144",
"telephone_number": "402-553-8769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11125 WOOLWORTH PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681441882",
"telephone_number": "402-553-8769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKUN",
"first_name": "JACQUELINE",
"middle_name": "GRAY",
"name_prefix": "Ms.",
"credential": "LADAC, LIMHP, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "6352",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "541",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "3316",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "909",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "773433000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025359000",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}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 Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.