Healthcare Provider Details

I. General information

NPI: 1295015469
Provider Name (Legal Business Name): OASIS COUNSELING INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST HIGHWAY 20
AINSWORTH NE
69210-0073
US

IV. Provider business mailing address

333 W NORFOLK AVE SUITE 201
NORFOLK NE
68701-5221
US

V. Phone/Fax

Practice location:
  • Phone: 402-387-1130
  • Fax: 402-387-1130
Mailing address:
  • Phone: 402-379-2030
  • Fax: 402-379-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNE

VIII. Authorized Official

Name: MR. MARK E STORTVEDT
Title or Position: EXECUTIVE DIRECTOR
Credential: LMHP
Phone: 402-379-2030