Individual provider Active NPI

Jennifer Lynne Eckhout, MS

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1841373826
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1966 Issued in NE
Practice address
1617 Normandy CT
Suite 100
Lincoln, NE 68512-1474
Phone
(402) 416-4444
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 1966 NE Primary

Addresses

Primary practice location

1617 Normandy CT
Suite 100
Lincoln, NE 68512-1474

Mailing address

3409 B St
Lincoln, NE 68510-4519
Phone (402) 416-4444

Other identifiers 2

IdentifierTypeStateIssuer
84709OtherNEBLUE CROSS BLUE SHIELD
246505OtherNEMIDLANDS CHOICE

Other names 1

  • Jennifer Lynne Wall Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1966NEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1841373826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 B ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104519",
            "telephone_number": "402-416-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 NORMANDY CT",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685121474",
            "telephone_number": "402-416-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHOUT",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84709",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "246505",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WALL",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.