Individual provider Active NPI

Thomas Lyle Dierks, L.C.S.W.

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1891822094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2337 Issued in NE
Practice address
2201 S. 17TH St.
Lincoln, NE 68502
Phone
(402) 441-6644
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2337 NE Primary

Addresses

Primary practice location

2201 S. 17TH St.
Lincoln, NE 68502

Mailing address

3510 R St
Lincoln, NE 68503-3335

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
I20100902001066 NE Practitioner - Clinical Social Worker 2062536626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4535 Normal Blvd
Suite 142
Lincoln, NE 68506-2891
Phone (402) 601-8154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2337NEMDPediatrics Physician
1025NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891822094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 R ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S. 17TH ST.",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68502",
            "telephone_number": "402-441-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "THOMAS",
        "middle_name": "LYLE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.