Benjila Willoughby

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

4924 Emmet St
Omaha, NE 68104-3656

Phone

(402) 739-2386

NPI assigned

Apr 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1891540225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 EMMET ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681043656",
            "telephone_number": "402-594-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 EMMET ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681043656",
            "telephone_number": "402-739-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "BENJILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breelyn Willmott
• Lane Weston Willmott
• Jeff Charles Willms
• Kellie M Willms, MS, LMHP
• Willoughby Counseling LLC
• Donna Willoughby, PLMHP
• Willow Counseling, LLC
• Willow Creek Health and Rehab LLC
• Willow Dental LLC
• Willow Dental Millard, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Omaha, NE
• Providers in Omaha, NE by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.