Individual provider Active NPI

Jacqueline Lynna Robinson, PLADC

  • Addiction (Substance Use Disorder) Counselor
  • Omaha, NE
National Provider Identifier
1972045607
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1340 Issued in NE
Practice address
4825 Ames Ave
Omaha, NE 68104-2383
Phone
(402) 301-6600
NPI assigned
Nov 11, 2016
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1340 NE Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2025 NM

Addresses

Primary practice location

4825 Ames Ave
Omaha, NE 68104-2383

Mailing address

5919 N 34TH St
Omaha, NE 68111-1260
Phone (402) 934-7294

Other practice location 1

6607 Maple St
Omaha, NE 68104-3901
Phone (402) 917-0926

Other practice location 2

400 Gold Ave SW Ste 1060
Albuquerque, NM 87102-3263
Phone (305) 450-9651

Other practice location 3

2808 N 75th St
Omaha, NE 68134-6861
Phone (402) 932-2248

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
I20250318001854 NE Practitioner - Mental Health Counselor 0941722003 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Development, LLC. CurrentSince Jan 5, 2025 Accepting new patients

Locations

6607 Maple St
Omaha, NE 68104
Phone (402) 917-0926

Organizations & group practices 1

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1972045607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919 N 34TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681111260",
            "telephone_number": "402-934-7294",
            "fax_number": "402-932-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 AMES AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681042383",
            "telephone_number": "402-301-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6607 Maple St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681043901",
            "country_code": "US",
            "telephone_number": "402-917-0926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Gold Ave SW Ste 1060",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871023263",
            "country_code": "US",
            "telephone_number": "305-450-9651",
            "fax_number": "305-418-7511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2808 N 75th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681346861",
            "country_code": "US",
            "telephone_number": "402-932-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JACQUELINE",
        "middle_name": "LYNNA",
        "credential": "PLADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1340",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "2025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.