SUSAN D WALLIS (NPI# 1740357813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740357813 |
| Entity Type | Individual |
| Full Name | SUSAN D WALLIS |
| Credential | PLMHP, PCMSW, MSW |
| Practice Address |
2101 S 42nd St Omaha NE 68105-2909 |
| Mailing Address |
5646 Ohio St Omaha NE 68104-4138 |
| Practice Telephone | 4025533000 |
| Mailing Telephone | 4088068156 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2018-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 11317 | NE | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 7196 | NE | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316065493 | Susan Wallis | Internal Medicine | 421 Huguenot St, Suite 44, New Rochelle, NY 10801-7004 | 2007-03-27 |
| Street Address |
2101 S 42ND ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68105-2909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929450 | Robert F Scheiblhofer | Counselor | 2101 S 42nd St, Omaha, NE 68105-2947 | 2005-08-15 |
| 1255945408 | Tara Bodlak | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2020-09-04 |
| 1083225999 | Lindsey Hylen | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2020-08-13 |
| 1033678693 | Brian Heidvogel | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2019-03-13 |
| 1225539356 | Kiara Taylor | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2018-02-23 |
| 1285148171 | Timothy Karstrom | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2017-11-30 |
| 1477070290 | Megan Wolff | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2017-08-23 |
| 1790226066 | Erin Talbert | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2017-03-20 |
| 1144778051 | Carly Spring | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2016-09-20 |
| 1578916961 | James Pennington | Counselor | 2101 S 42nd St, Omaha, NE 68105-2909 | 2016-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679018030 | Buoyant Family Services Counseling and Consulting LLC | Community/Behavioral Health | The Center 1941 South 42nd Street, Suite 416 S, Omaha, NE 68105 | 2016-12-21 |
| 1497104442 | Michael Lee Powell | Family Medicine | 4305 Dewey Ave, Omaha, NE 68105 | 2016-06-10 |
| 1164896361 | Kyla Haner | Counselor | 1941 S. 42nd St. Ste 514, Omaha, NE 68105 | 2015-11-25 |
| 1114359189 | Kayli Ann Bendlin | Pharmacist | 4101 Woolworth Ave.-mailstop 119, Va Medical Center-pharmacy Department, Omaha, NE 68105 | 2013-08-01 |
| 1740622372 | Ashley M Ortiz | Nurse Practitioner | 4350 Dewey Avenue, Omaha, NE 68105 | 2013-07-24 |
| 1043519655 | Mandy J Hansen | Counselor | 2101 S. 42nd Street, Omaha, NE 68105 | 2011-03-22 |
| 1851537302 | Magda Maria Blanco | Counselor | 1941 South 42nd St Suite 541, Suite 541, Omaha, NE 68105 | 2009-01-05 |
| 1609050848 | James Joseph Shehan | Internal Medicine | 4100 Woolworth, Omaha, NE 68105 | 2007-12-24 |
| 1407051477 | Cristian D Clark | Counselor | 2101 S 42nd Street, Heartland Family Service, Omaha, NE 68105 | 2007-06-19 |
| 1831312305 | Kelli Renae Welvaert | Counselor | 2101 So 42 St, Heartland Family Service, Omaha, NE 68105 | 2007-04-11 |
| Find all providers in zip 68105 | ||||
| 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.