Healthcare Provider Details

I. General information

NPI: 1568237584
Provider Name (Legal Business Name): LESLIE STEVENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10100 CEDAR ISLAND RD
BELLEVUE NE
68123-5048
US

IV. Provider business mailing address

600 KENT DR
PAPILLION NE
68046-4176
US

V. Phone/Fax

Practice location:
  • Phone: 402-916-9421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13391
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: