Healthcare Provider Details

I. General information

NPI: 1912253394
Provider Name (Legal Business Name): SANDRA M RANEY LMHP, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 9TH ST
GERING NE
69341-2950
US

IV. Provider business mailing address

2021 BROADWAY
SCOTTSBLUFF NE
69361-1903
US

V. Phone/Fax

Practice location:
  • Phone: 308-225-4335
  • Fax: 308-633-2020
Mailing address:
  • Phone: 308-225-4335
  • Fax: 308-633-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1047
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9689
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: