Healthcare Provider Details
I. General information
NPI: 1629905898
Provider Name (Legal Business Name): OPEN GATE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1453 29TH AVE STE 6
COLUMBUS NE
68601-4949
US
IV. Provider business mailing address
1453 29TH AVE STE 6
COLUMBUS NE
68601-4949
US
V. Phone/Fax
- Phone: 402-910-3884
- Fax:
- Phone: 402-910-3884
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIANNE
LAUDENKLOS
Title or Position: LICENSED INDEPENDENT MENTAL HEALTH
Credential: LIMHP
Phone: 402-910-3884