Healthcare Provider Details

I. General information

NPI: 1972443059
Provider Name (Legal Business Name): AMANDA KEATING PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 9TH ST
COZAD NE
69130-1737
US

IV. Provider business mailing address

502 W 10TH ST
COZAD NE
69130-1301
US

V. Phone/Fax

Practice location:
  • Phone: 308-746-2230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14916
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: