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NPI Code Detail

MEDICARE: NICHOLSON MONTOUR CLINICIAN

MEDICARE: NICHOLSON MONTOUR CLINICIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578814307
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLSON MONTOUR CLINICIAN
Provider Business Mailing Address
First Line : 2633 P ST
Second Line :
City : LINCOLN
State : NE
Zip : 68503-3528
Country : US
Telephone Number : 402-475-8717
Fax Number : 402-475-8721
Provider Business Practice Location Address
First Line : 2202 S 11TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68502-3559
Country : US
Telephone Number : 402-475-5161
Fax Number : 402-475-8721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 10/19/2023

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Directions to “ NICHOLSON MONTOUR CLINICIAN” Practice Location

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