Active NPI
Susan Diane Nelsen, MS, LMHP, CPC, NCC
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1861509952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1546
- Practice address
- 11920 Burt Street
#190
Omaha, NE 68154 - Phone
- (402) 965-4004
- Fax
- (402) 965-4232
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1546 | NE | Primary |
| Mental Health Counselor | 101YM0800X | 957 | NE |
Addresses
Primary practice location
11920 Burt Street
#190
Omaha, NE 68154
Mailing address
11920 Burt Street
#190
Omaha, NE 68154
Phone (402) 965-4004
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84677 | Other | NE | BLUECROSS BLUESHIELD |
| 100253006-00 | Medicaid | NE |
Other names 1
- Susan Hoffman
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
| License | State | Type | Specialty |
|---|---|---|---|
| 957 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861509952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11920 BURT STREET",
"address_2": "#190",
"city": "OMAHA",
"state": "NE",
"postal_code": "68154",
"telephone_number": "402-965-4004",
"fax_number": "402-965-4232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11920 BURT STREET",
"address_2": "#190",
"city": "OMAHA",
"state": "NE",
"postal_code": "68154",
"telephone_number": "402-965-4004",
"fax_number": "402-965-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSEN",
"first_name": "SUSAN",
"middle_name": "DIANE",
"name_prefix": "Ms.",
"credential": "MS, LMHP, CPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "1546",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "957",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "84677",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100253006-00",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "HOFFMAN",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.