Individual provider Active NPI

Amy Marie Hagler, PCMSW AND PLMHP

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1912650623
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12813 Issued in NE
Practice address
11071 W Maple Rd
Omaha, NE 68164-2604
Phone
(402) 932-8884
Fax
(402) 932-8885
NPI assigned
Feb 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7680 NE
Mental Health Counselor 101YM0800X 12813 NE
Clinical Social Worker 1041C0700X 7680 NE
Clinical Social Worker 1041C0700X 12813 NE Primary

Addresses

Primary practice location

11071 W Maple Rd
Omaha, NE 68164-2604

Mailing address

11071 W Maple Rd
Omaha, NE 68164-2604
Phone (402) 932-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12813NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1912650623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11071 W MAPLE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681642604",
            "telephone_number": "402-932-8884",
            "fax_number": "402-932-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11071 W MAPLE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681642604",
            "telephone_number": "402-932-8884",
            "fax_number": "402-932-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGLER",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "PCMSW AND PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "7680",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12813",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "7680",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "12813",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 2, 2022; 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.