Healthcare Provider Details

I. General information

NPI: 1053969360
Provider Name (Legal Business Name): MISTY D WARREN LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 S 221ST ST
ELKHORN NE
68022-3342
US

IV. Provider business mailing address

4520 S 221ST ST
ELKHORN NE
68022-3342
US

V. Phone/Fax

Practice location:
  • Phone: 402-670-8850
  • Fax:
Mailing address:
  • Phone: 402-670-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100111
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11977
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2607
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2607
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: