Active NPI
Jennifer Diaz
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1790147098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10155
- Practice address
- 11414 W Center Rd Ste 140
Omaha, NE 68144-4487 - Phone
- (402) 238-4380
- NPI assigned
- Mar 25, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10155 | NE | Primary |
Addresses
Primary practice location
11414 W Center Rd Ste 140
Omaha, NE 68144-4487
Mailing address
4906 Sigwart Ave
Omaha, NE 68104
Phone (402) 238-4380
Other practice location 1
965 Patricia Dr
Papillion, NE 68046-2922
Phone (402) 932-7788
Other practice location 2
4906 Sigwart ave
Omaha, NE 68104
Phone (402) 238-4380
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10155 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| House Enterprises Inc | Past | Accepting new patients |
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.
-
dba Daybreak
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Papillion, NE
- NPI 1285929844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545091200000",
"number": "1790147098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4906 SIGWART AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "68104",
"telephone_number": "402-238-4380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11414 W CENTER RD STE 140",
"city": "OMAHA",
"state": "NE",
"postal_code": "681444487",
"telephone_number": "402-238-4380"
}
],
"practiceLocations": [
{
"address_1": "965 Patricia Dr",
"address_purpose": "LOCATION",
"city": "Papillion",
"state": "NE",
"postal_code": "680462922",
"country_code": "US",
"telephone_number": "402-932-7788",
"fax_number": "402-933-7464",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4906 Sigwart ave",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "68104",
"country_code": "US",
"telephone_number": "402-238-4380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIAZ",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-25",
"last_updated": "2018-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "10155",
"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 Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.