Healthcare Provider Details

I. General information

NPI: 1225186463
Provider Name (Legal Business Name): ALLEN L MINNIG LMHP,LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2382 COUNTY ROAD 45
FORT CALHOUN NE
68023-5028
US

IV. Provider business mailing address

2382 COUNTY ROAD 45
FORT CALHOUN NE
68023-5028
US

V. Phone/Fax

Practice location:
  • Phone: 402-661-0115
  • Fax:
Mailing address:
  • Phone: 402-661-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3398
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1720
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: