Individual provider Active NPI

Riley Alice Mitas, PLMHP

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1730805672
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7759 Issued in NE
Practice address
11404 W Dodge Rd Ste 300
Omaha, NE 68154-2511
Phone
(402) 898-1113
Fax
(402) 819-5588
NPI assigned
Oct 12, 2022
Last updated
Oct 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7759 NE Primary

Addresses

Primary practice location

11404 W Dodge Rd Ste 300
Omaha, NE 68154-2511

Mailing address

11404 W Dodge Rd Ste 300
Omaha, NE 68154-2511
Phone (402) 898-1113

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

LicenseStateTypeSpecialty
7759NEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1730805672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 W DODGE RD STE 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542511",
            "telephone_number": "402-898-1113",
            "fax_number": "402-819-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11404 W DODGE RD STE 300",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542511",
            "telephone_number": "402-898-1113",
            "fax_number": "402-819-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITAS",
        "first_name": "RILEY",
        "middle_name": "ALICE",
        "credential": "PLMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "7759",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.