Healthcare Provider Details

I. General information

NPI: 1508002106
Provider Name (Legal Business Name): MARNIE HERMAN SCHIEFFER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2009
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55549 HIGHWAY12
CROFTON NE
68730-0000
US

IV. Provider business mailing address

55549 HIGHWAY12 PO BOX 170
CROFTON NE
68730-0000
US

V. Phone/Fax

Practice location:
  • Phone: 402-388-4532
  • Fax: 402-357-3501
Mailing address:
  • Phone: 402-388-4532
  • Fax: 402-357-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2928
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3810
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1382
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: