MS. KRISTY LYNN MIXAN (NPI# 1104965896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104965896 |
| Entity Type | Individual |
| Full Name | MS. KRISTY LYNN MIXAN |
| Practice Address |
425 N 30th St Omaha NE 68131-2100 |
| Mailing Address |
555 N 30th St Omaha NE 68131-2136 |
| Practice Telephone | 4024525000 |
| Practice Fax Number | 4024525028 |
| Mailing Telephone | 4022808100 |
| Mailing Fax Number | 4022808103 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2010-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 1422 | NE | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BCBS ENT | 84445 | 01 |
| NE | BCBS BT | 84366 | 01 |
| Street Address |
425 N 30TH ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68131-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780734079 | Jeffrey L Simmons | Audiologist | 425 N 30th St, Omaha, NE 68131-2100 | 2007-01-11 |
| 1477053866 | Joshua Dale Sevier | Audiologist | 425 N 30th St, Omaha, NE 68131-2100 | 2018-02-13 |
| 1417468752 | Abby Joan Bogatz | Speech-Language Pathologist | 425 N 30th St, Omaha, NE 68131-2100 | 2017-10-13 |
| 1649580879 | Jacquelyn Lea Baudhuin | Audiologist | 425 N 30th St, Omaha, NE 68131-2100 | 2010-10-21 |
| 1417280900 | Emilie Sweet | Speech-Language Pathologist | 425 N 30th St, Omaha, NE 68131-2100 | 2009-09-15 |
| 1336472828 | Sara Robinson | Speech-Language Pathologist | 425 N 30th St, Omaha, NE 68131-2100 | 2009-09-15 |
| 1205063484 | Jenny Lee Goehring | Audiologist | 425 N 30th St, Omaha, NE 68131-2100 | 2009-06-16 |
| 1417101098 | Lauren M Unflat Berry | Speech-Language Pathologist | 425 N 30th St, Omaha, NE 68131-2100 | 2008-11-10 |
| 1356482046 | Carla Louisa O Reyes | Audiologist | 425 N 30th St, Omaha, NE 68131-2100 | 2007-02-08 |
| 1821144874 | Patricia Joan Gill | Speech-Language Pathologist | 425 N 30th St, Omaha, NE 68131-2100 | 2007-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626086 | Spring Forward Ot, LLC | Occupational Therapist | 429 N. 38th Ave, Omaha, NE 68131 | 2020-03-31 |
| 1568944528 | Amy Vodicka | Case Manager/Care Coordinator | 3612 Cuming St., Omaha, NE 68131 | 2018-09-05 |
| 1982121919 | Lakeisha Marie Phelps | Peer Specialist | 3568 Dodge St, Omaha, NE 68131 | 2017-08-30 |
| 1063939098 | William L. Rolfe | Community Health Worker | 3568 Dodge Street, Suite 2, Omaha, NE 68131 | 2017-08-30 |
| 1578086294 | Nebraska Family Support Network | Community/Behavioral Health | 3568 Dodge St Ste 2, Omaha, NE 68131 | 2017-07-25 |
| 1124558937 | Beverly Hamilton | Case Manager/Care Coordinator | 3612 Cuming, Omaha, NE 68131 | 2017-06-14 |
| 1396291068 | Elizabeth George | Internal Medicine | 601 N. 30th St. Cu Department of Internal Medicine, Omaha, NE 68131 | 2016-08-31 |
| 1639625999 | Samuel Ramon Brown | Surgery | 601 N. 30th St. Cu Department of Surgery, Omaha, NE 68131 | 2016-08-28 |
| 1205289238 | Srilakshmi Reddy | Surgery | 601 N 30th St -cu Department of General Surgery, Omaha, NE 68131 | 2016-07-14 |
| 1881069409 | Jordan Sieh | Behavioral Analyst | 444 S. 44th St, Omaha, NE 68131 | 2015-12-08 |
| Find all providers in zip 68131 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868114 | Blue Sky Counseling LLC | Counselor | 16766 M Cir, Omaha, NE 68135-1314 | 2020-07-08 |
| 1851920979 | Saint Francis Ministries In Nebraska, Inc. | Counselor | 3311 N 93rd St, Omaha, NE 68134-4727 | 2020-04-02 |
| 1275166811 | Miriam Commodore-mensah | Counselor | 1941 S 42nd St Ste 375, Omaha, NE 68105-2958 | 2020-02-21 |
| 1972141893 | Incrementling Peace Counseling Services LLC. | Counselor | 3035 Harney Street, Tamarak Building Suite 101 G, Omaha, NE 68131-3500 | 2019-12-11 |
| 1235792821 | Vera Lynn Petersen | Counselor | 1441 N 11th St, Omaha, NE 68102-4202 | 2019-04-18 |
| 1134685563 | Vivian D Wright | Counselor | 4401 N 21st St, Omaha, NE 68110-1614 | 2019-02-11 |
| 1336603810 | Turning The Mind Therapy | Counselor | 4611 S 96th St Ste 232, Omaha, NE 68127-1243 | 2019-01-29 |
| 1780167676 | Kaitlin Carlson | Counselor | 1941 S 42nd St Ste 385, Omaha, NE 68105-2943 | 2018-09-07 |
| 1427547801 | Monica Lee Massengale | Counselor | 3414 S 122nd St, Omaha, NE 68144-4234 | 2018-05-01 |
| 1770084139 | Paula Cellar | Counselor | 13330 Larimore Ave Apt 209, Omaha, NE 68164-6330 | 2018-02-21 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.