MS. JAYNE LYNN GUNDRUM (LMHP) – Mental Health Counselor, NPI 1710979851
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
852 MENTAL HEALTH COUNSELOR in NE
Provider Addresses for MS. JAYNE LYNN GUNDRUM (LMHP)
17201 WRIGHT ST
OMAHA, NE 681302042
Phone: (402) 691-6977
Fax: (402) 445-8017
Type: Location
3325 N 148TH CT
APT #3208
OMAHA, NE 681167212
Phone: (402) 884-6430
Type: Mailing
11212-11222, Davenport Street, Omaha, Douglas County, Nebraska, 68154, United States
OMAHA, NE 681545624
Phone: (402) 552-7011
Fax: (402) 552-7016
Type: Location
16098 WEBER ST
BENNINGTON, NE 680077480
Phone: (402) 216-9506
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-11-22
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231122000159 | I | Mental Health Counselor | NE | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 68130)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NE | |
| - | IA | |
| H E M A T O L O G Y/ O N C O L O G Y | NE | |
| H E M A T O L O G Y/ O N C O L O G Y | MO | |
| Nurse Practitioner | NE | |
| H E M A T O L O G Y/ O N C O L O G Y | NE | |
| Medical Oncology, Hematology | NE | |
| Nurse Practitioner | NE | |
| Medical Oncology, Hematology | NE | |
| - | NE |
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