Individual provider Active NPI

Mary M Tidyman, LIMHP, LADC

  • Mental Health Counselor
  • North Platte, NE
National Provider Identifier
1861793085
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4624 Issued in NE
Practice address
110 N Bailey
North Platte, NE 69101
Phone
(308) 534-6029
Fax
(308) 534-6961
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1280 NE
Mental Health Counselor 101YM0800X 4624 NE Primary

Addresses

Primary practice location

110 N Bailey
North Platte, NE 69101

Mailing address

PO Box 1208
North Platte, NE 69103-1208
Phone (308) 534-6029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131001066 NE Practitioner - Mental Health Counselor 4587017199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Region II Human ServicesGroup PAC ID 0143280651, 15 clinicians

Practice addresses (Care Compare)

110 N Bailey Ave
North Platte, NE 69101-5436
Phone (308) 534-6029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14180NEMDMental Health Counselor
1280NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Region II Human Services CurrentSince Jan 1, 2024 Accepting new patients
Region II Human Services CurrentSince Jan 1, 2024 Accepting new patients
Region II Human Services Current Accepting new patients

Locations

1012 W 3rd St
McCook, NE 69001
Phone (308) 345-2770

110 N Bailey Ave
North Platte, NE 69101
Phone (308) 532-4860

401 W 1st St
Ogallala, NE 69153
Phone 3082846767 ext. 206

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1861793085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1208",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691031208",
            "telephone_number": "308-534-6029",
            "fax_number": "308-534-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N BAILEY",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "69101",
            "telephone_number": "308-534-6029",
            "fax_number": "308-534-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDYMAN",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "LIMHP, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1280",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.