Healthcare Provider Details

I. General information

NPI: 1063987717
Provider Name (Legal Business Name): ALLISON NICOLE SAND MA, LIMHP, CPC, PLAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 HOSPITAL PKWY
BEATRICE NE
68310-6906
US

IV. Provider business mailing address

PO BOX 278
BEATRICE NE
68310-0278
US

V. Phone/Fax

Practice location:
  • Phone: 402-228-3344
  • Fax: 402-223-6565
Mailing address:
  • Phone: 402-228-3344
  • Fax: 402-223-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11675
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-1627
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2604
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2436
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: