Active NPI
Eleanore Shrader, LMHP, PC
- Counselor
- Omaha, NE
National Provider Identifier
1881096493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 4882
- Practice address
- 11304 Elm St
Omaha, NE 68144-4733 - Phone
- (402) 858-9607
- Fax
- (402) 973-9567
- NPI assigned
- Sep 25, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4882 | NE | Primary |
Addresses
Primary practice location
11304 Elm St
Omaha, NE 68144-4733
Mailing address
13460 Walsh Dr
Boys Town, NE 68010-7529
Phone (402) 498-3358
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10026139700 | Medicaid | NE | |
| 47037660631 | Medicaid | NE | |
| 10025745300 | Medicaid | NE |
Other names 1
- Eleanore Tardy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4882 | NE | MD | Counselor |
| 2451 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shrader Psychotherapy L.L.C | Current | Accepting new patients |
Locations
11304 Elm St
Omaha, NE 68144
Phone (402) 858-9607
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Omaha, NE
- NPI 1235853763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1881096493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13460 WALSH DR",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107529",
"telephone_number": "402-498-3358",
"fax_number": "402-498-3375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11304 ELM ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681444733",
"telephone_number": "402-858-9607",
"fax_number": "402-973-9567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRADER",
"first_name": "ELEANORE",
"credential": "LMHP, PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-25",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NE",
"license": "4882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026139700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47037660631",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025745300",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELEANORE",
"last_name": "TARDY",
"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 Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.