MEDICARE: NOURISH & FLOURISH THERAPY LLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1659261253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOURISH & FLOURISH THERAPY LLC

Provider Business Mailing Address
First Line	:	15928 SPRING ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-1958
Country	:	US
Telephone Number	:	402-802-6709
Fax Number	:

Provider Business Practice Location Address
First Line	:	10846 OLD MILL RD STE 2
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2652
Country	:	US
Telephone Number	:	402-802-6709
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LINDSEY K PHELPS
Credential	:	LMHC LIMHP
Telephone Number	:	402-802-6709

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/07/2025

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