NPIMap

Organization Active NPI

Fireside Counseling LLC

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1851766034
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FIRESIDE COUNSELING LLC
Practice address
7701 Pacific St Ste 100
Omaha, NE 68114-5480
Phone
(402) 216-1789
NPI assigned
Dec 14, 2015
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Mr. Michael Andrew Green, LIMHPNPI 1063744167
Title
Therapist
Phone
(402) 216-1789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

7701 Pacific St Ste 100
Omaha, NE 68114-5480

Mailing address

7701 Pacific St Ste 100
Omaha, NE 68114-5480
Phone (402) 216-1789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200616001495 NE Part B Supplier - Clinic/Group Practice 9436571601 Receives reassigned benefits from 9 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

7701 Pacific St
Ste 100
Omaha, NE 68114
Phone (402) 216-1789

8309 Cass St
Omaha, NE 68114
Phone (402) 397-8891

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1851766034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 PACIFIC ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681145480",
            "telephone_number": "402-216-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 PACIFIC ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681145480",
            "telephone_number": "402-216-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRESIDE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "402-216-1789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LIMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "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 Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.