Brandon Pedersen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10935 Issued in NE

Practice address

10826 Old Mill Rd
Omaha, NE 68154-2660

Phone

(402) 671-3750

NPI assigned

Aug 31, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Truth and Restoration LLC

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1245808922
  NPD

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1972059632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10826 OLD MILL RD STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542660",
            "telephone_number": "402-671-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10826 OLD MILL RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542660",
            "telephone_number": "402-671-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4026713750",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon L Pecka, CRNA
• Tiffany Peckham
• Wendy L Pecoraro, APRN
• Brittany Sue Peden
• Amy Pedersen
• Carrie Ann Pedersen, L.C.S.W.
• Erik Andrew Pedersen, MD
• Jody A Pedersen, APRN
• Katherine Elaine Pedersen
• Kelli Lynee Pedersen

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.