MEDICARE: JEAN TROXELL

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	301	NE
2	101YM0800X	Mental Health Counselor	1692	NE

General Provider Information

NPI Number	:	1932340858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN TROXELL

Provider Business Mailing Address
First Line	:	3300 N 60TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-3402
Country	:	US
Telephone Number	:	402-554-0520
Fax Number	:	402-551-8797

Provider Business Practice Location Address
First Line	:	3300 N 60TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-3402
Country	:	US
Telephone Number	:	402-554-0520
Fax Number	:	402-551-8797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	08/28/2013

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Directions to “ JEAN TROXELL ” Practice Location

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