NPIMap

Organization Active NPI

Specialized Outpatient Services

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1942848593
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SPECIALIZED OUTPATIENT SERVICES
Practice address
1811 West 2ND Street Suite 450
Grand Island, NE 68803
Phone
(308) 379-8619
Fax
(308) 384-0194
NPI assigned
Dec 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Authorized official

Name
Ms. Cynthia L Kissack, LIMHP
Title
Mental Health Practioner
Phone
(308) 379-8619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1811 West 2ND Street Suite 450
Grand Island, NE 68803

Mailing address

1811 West 2ND Street Suite 450
Grand Island, NE 68803
Phone (308) 379-8619

National Provider Directory

National Provider Directory
Tax ID family
Specialized Outpatient Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1942848593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 WEST 2ND STREET SUITE 450",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "68803",
            "telephone_number": "308-379-8619",
            "fax_number": "308-384-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 WEST 2ND STREET SUITE 450",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "68803",
            "telephone_number": "308-379-8619",
            "fax_number": "308-384-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED OUTPATIENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "KISSACK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MENTAL HEALTH PRACTIONER",
        "authorized_official_telephone_number": "308-379-8619",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LIMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.