Individual provider Active NPI

Shyanne Moses

  • Mental Health Counselor
  • Papillion, NE
National Provider Identifier
1780303628
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14211 Issued in NE
Practice address
1237 Golden Gate Dr
Papillion, NE 68046-2837
Phone
(402) 614-0175
NPI assigned
Aug 24, 2022
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 14211 NE Primary

Addresses

Primary practice location

1237 Golden Gate Dr
Papillion, NE 68046-2837

Mailing address

1237 Golden Gate Dr
Papillion, NE 68046-2837
Phone (402) 614-0175

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
14211NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Integrated Care PLLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1237 Golden Gate Dr
Papillion, NE 68046
Phone (402) 590-2947

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1780303628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 GOLDEN GATE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680462837",
            "telephone_number": "402-614-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 GOLDEN GATE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680462837",
            "telephone_number": "402-614-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "SHYANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "14211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.