{
"Npi": {
"NPI": "1720561012",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WIPF",
"FirstName": "MEREDITH",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMHP, LCMSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5619 S 19TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OMAHA",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68107-3601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "531-299-8862",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11605 MIRACLE HILLS DR STE 300",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OMAHA",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68154-4467",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "402-238-1431",
"PracticeLocationAddressFaxNumber": "402-281-1862",
"EnumerationDate": "09/12/2018",
"LastUpdateDate": "06/03/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "2068",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041S0200X",
"TaxonomyName": "School Social Worker",
"LicenseNumber": "11226",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041S0200X",
"TaxonomyName": "School Social Worker",
"LicenseNumber": "7169",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "5711",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}