1. Home
  2. Directory
  3. Nebraska
  4. Lincoln
  5. Clinic Center
  6. NPI Profile

PINE LAKE BEHAVIORAL HEALTH
NPI 1003310061
Clinic/Center in Lincoln, NE

Active since March 22, 2018CLIA 28D2077900 · Waiver
9100 ANDERMATT DRIVE SUITE 1, LINCOLN, NE 68526(402) 434-2730(402) 434-3970 Get Directions Write a Review

NPPES record last updated: February 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 24, 2020, Feb 26, 2019, Mar 22, 2018 (3 updates tracked since 2018).

About Pine Lake Behavioral Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE LAKE BEHAVIORAL HEALTH (NPI 1003310061) is a healthcare organization registered as a clinic/center in Lincoln, Nebraska and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through May 15, 2028 and lists Jared Wade Ray, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1003310061
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePINE LAKE BEHAVIORAL HEALTH, LLC.
Location Address9100 ANDERMATT DRIVE SUITE 1Lincoln, NE 68526-0000
Mailing Address9100 Andermatt Dr Ste 1Lincoln, NE 68526-6700 · (402) 434-2730 · Fax (402) 434-3970
Phone(402) 434-2730
Fax(402) 434-3970
Organization SubpartNo
Authorized OfficialJared Wade RayDirector Of Operations · (402) 434-2730
Enumeration DateMarch 22, 2018
Last NPPES UpdateFebruary 24, 20203 updates tracked since enumeration
✔ NPI 1003310061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedPharmacyTaxonomy 333600000X
9100 ANDERMATT DRIVE SUITE 1, Lincoln, NE 68526
Open in Google Maps ↗

Other Names 1

Doing Business AsPine Lake Behavioral Health

Other Identifiers 4

OtherNA3283NE · Medicare Ptan
Medicaid10026721201NE
OtherDY5949NE · Rr Medicare Ptan
Medicaid10026721200NE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Nebraska, Medica, Oscar Insurance Company and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 28D2077900

Pine Lake Behavioral Health · Lincoln, NE
Active · expires May 15, 2028
CLIA Number28D2077900
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateMay 16, 2026
Certificate Expiration DateMay 15, 2028
Laboratory DirectorMr. Jared Ray
Laboratory Phone(402) 434-2730
Laboratory LocationPine Lake Behavioral Health9100 Andermatt Drive, Suite 1, Lincoln, NE 68526
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LISA JONES PHD
Psychologist (Clinical)
9100 ANDERMATT DRIVE SUITE 1
LINCOLN, NE 68526
Lancaster County (402) 434-2730
MR. WILLIAM WYSOCKI LIMHP
Counselor (Mental Health)
9100 ANDERMATT DRIVE SUITE 1
LINCOLN, NE 68526
Lancaster County (402) 434-2730
MR. JARED RAY LIMHP, LADC, CPC
Counselor (Mental Health)
9100 ANDERMATT DRIVE SUITE 1
LINCOLN, NE 68526
Lancaster County (402) 434-2730
DR. RICK MCNEESE PH.D.
Psychologist
9100 ANDERMATT DRIVE SUITE 1
LINCOLN, NE 68526
Lancaster County (402) 434-2730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Lake Behavioral Health, LLC.'s NPI number?

The NPI number for Pine Lake Behavioral Health, LLC. is 1003310061. It was assigned to this organization in the NPPES registry on March 22, 2018. The provider is doing business as Pine Lake Behavioral Health.

Where is Pine Lake Behavioral Health, LLC. located?

Pine Lake Behavioral Health, LLC. is located at 9100 Andermatt Drive Suite 1, Lincoln, NE 68526. The listed phone number is (402) 434-2730.

What is Pine Lake Behavioral Health, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Pine Lake Behavioral Health, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D2077900) is associated with this NPI, valid through May 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pine Lake Behavioral Health, LLC. accept?

Health plans from Blue Cross and Blue Shield of Nebraska, Medica, Oscar Insurance Company and UnitedHealthcare list Pine Lake Behavioral Health, LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pine Lake Behavioral Health, LLC. was last updated on February 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.