NPIMap

Organization Active NPI

Southern Sudan Comm Ass

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1861518763
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOUTHERN SUDAN COMM ASS
Practice address
3610 Dodge Street
Suite 100
Omaha, NE 68131
Phone
(402) 554-0759
Fax
(402) 561-9724
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Julia H Allen, LMHPNPI 1467574509
Title
Supervising LMHP
Phone
(402) 554-0759

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3610 Dodge Street
Suite 100
Omaha, NE 68131

Mailing address

3610 Dodge Street
Suite 100
Omaha, NE 68131
Phone (402) 554-0759

Other identifiers 1

IdentifierTypeStateIssuer
10025485800MedicaidNE

National Provider Directory

National Provider Directory

Locations

3610 Dodge St
Ste 100
Omaha, NE 68131
Phone (402) 578-2674

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861518763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 DODGE STREET",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68131",
            "telephone_number": "402-554-0759",
            "fax_number": "402-561-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 DODGE STREET",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68131",
            "telephone_number": "402-554-0759",
            "fax_number": "402-561-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SUDAN COMM ASS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SUPERVISING LMHP",
        "authorized_official_telephone_number": "402-554-0759",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025485800",
            "state": "NE"
        }
    ],
    "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 Aug 22, 2020; 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.