Active NPI
Jena Uphold
- Mental Health Counselor
- Lincoln, NE
National Provider Identifier
1962995332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12634
- Practice address
- 4545 S 86TH St
Lincoln, NE 68526-9262 - Phone
- (402) 483-6990
- NPI assigned
- Jun 11, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 12634 | NE | Primary |
Addresses
Primary practice location
4545 S 86TH St
Lincoln, NE 68526-9262
Mailing address
4545 S 86TH St
Lincoln, NE 68526-9262
Other practice location 1
1738 S Tremont St
Oceanside, CA 92054-5309
Phone (760) 439-2800
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 |
|---|---|---|---|
| 12634 | NE | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1962995332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 S 86TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 S 86TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269262",
"telephone_number": "402-483-6990"
}
],
"practiceLocations": [
{
"address_1": "1738 S Tremont St",
"address_purpose": "LOCATION",
"city": "Oceanside",
"state": "CA",
"postal_code": "920545309",
"country_code": "US",
"telephone_number": "760-439-2800",
"fax_number": "760-433-5031",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UPHOLD",
"first_name": "JENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "12634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.