Active NPI
Kelli Lynee Pedersen
- Professional Counselor
- Omaha, NE
National Provider Identifier
1942160403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 14683
- Practice address
- 1941 S 42ND St Ste 402
Omaha, NE 68105-2944 - Phone
- (402) 401-4445
- NPI assigned
- Nov 17, 2025
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14683 | NE | Primary |
Addresses
Primary practice location
1941 S 42ND St Ste 402
Omaha, NE 68105-2944
Mailing address
1941 S 42ND St Unit 2
Omaha, NE 68105-2939
Phone (402) 401-4445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14683 | NE | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1942160403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1941 S 42ND ST UNIT 2",
"city": "OMAHA",
"state": "NE",
"postal_code": "681052939",
"telephone_number": "402-401-4445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1941 S 42ND ST STE 402",
"city": "OMAHA",
"state": "NE",
"postal_code": "681052944",
"telephone_number": "402-401-4445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSEN",
"first_name": "KELLI",
"middle_name": "LYNEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-17",
"last_updated": "2025-11-17",
"certification_date": "2025-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "14683",
"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 Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.