Healthcare Provider Details

I. General information

NPI: 1831614064
Provider Name (Legal Business Name): GREAT PLAINS MENTAL HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 S 133RD ST STE 109
OMAHA NE
68137-1133
US

IV. Provider business mailing address

4610 S 133RD ST STE 109
OMAHA NE
68137-1133
US

V. Phone/Fax

Practice location:
  • Phone: 402-614-0010
  • Fax: 402-614-0090
Mailing address:
  • Phone: 402-614-0010
  • Fax: 402-614-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number111379
License Number StateNE

VIII. Authorized Official

Name: PAULA A WHITTLE
Title or Position: OWNER/PRESIDENT
Credential: APRN
Phone: 402-614-0010