NPIMap

Individual provider Active NPI

Karen M Gustafson, LMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1750472189
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
920 Issued in NE
Practice address
333 South 132D Street
Omaha, NE 68154
Phone
(402) 330-2024
Fax
(402) 697-7019
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2002 NE
Professional Counselor 101YP2500X 2002 NE
Mental Health Counselor 101YM0800X 920 NE Primary

Addresses

Primary practice location

333 South 132D Street
Omaha, NE 68154

Mailing address

333 South 132D Street
Omaha, NE 68154
Phone (402) 330-2024

Other identifiers 2

IdentifierTypeStateIssuer
13006OtherNEMIDLANDS CHOICE
84887OtherNEBCBS

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
920NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
KG Counseling, LLC Mental Health Current Accepting new patients
Jewish Federation of Omaha, Inc Current Accepting new patients
Jewish Federation of Omaha, Inc. Current Accepting new patients

Locations

333 S 132nd St
Omaha, NE 68154
Phone (402) 330-2024

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1750472189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SOUTH 132D STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-330-2024",
            "fax_number": "402-697-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SOUTH 132D STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-330-2024",
            "fax_number": "402-697-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "KAREN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2002",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "2002",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "13006",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84887",
            "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 Dec 16, 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.

Verify at the official NPI Registry.