Healthcare Provider Details

I. General information

NPI: 1548318207
Provider Name (Legal Business Name): JAMIE LYNN MONFELT-SIEMS M.A., LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 COURT ST
BEATRICE NE
68310-3926
US

IV. Provider business mailing address

321 W D ST
WYMORE NE
68466-2119
US

V. Phone/Fax

Practice location:
  • Phone: 402-223-3843
  • Fax: 402-223-4200
Mailing address:
  • Phone: 402-520-3924
  • Fax: 402-223-4200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3280
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: