Healthcare Provider Details

I. General information

NPI: 1114153962
Provider Name (Legal Business Name): FISHER-EDENS & KLEIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 10TH ST
GERING NE
69341-2417
US

IV. Provider business mailing address

2027 10TH ST
GERING NE
69341-2417
US

V. Phone/Fax

Practice location:
  • Phone: 308-632-4200
  • Fax: 308-632-4205
Mailing address:
  • Phone: 308-632-4200
  • Fax: 308-632-4205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3209
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1541
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2977
License Number StateNE

VIII. Authorized Official

Name: TERRY FISHER-EDENS
Title or Position: PARTNER
Credential: LMHP, LPC
Phone: 308-632-4200