Healthcare Provider Details

I. General information

NPI: 1275469769
Provider Name (Legal Business Name): ALLY IBSEN PLMHP, PMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 25TH ST
COLUMBUS NE
68601-2233
US

IV. Provider business mailing address

1203 S 8TH ST
NORFOLK NE
68701-5875
US

V. Phone/Fax

Practice location:
  • Phone: 402-500-6870
  • Fax:
Mailing address:
  • Phone: 402-500-6870
  • Fax: 402-500-6871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8392
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14982
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: