=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598259640
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JH WELLNESS SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2018
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8920 BUCKSKIN CT
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68520-1185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-913-0270
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 471
-----------------------------------------------------
City | WALTON
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68461-0471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-913-0270
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. JENNIFER HAGEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-913-0270
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 3274
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------