Healthcare Provider Details

I. General information

NPI: 1598891467
Provider Name (Legal Business Name): LISA MARIE OSTHOFF MA, LPC, LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 10TH ST
GERING NE
69341-1724
US

IV. Provider business mailing address

2901 PRIMROSE DR
SCOTTSBLUFF NE
69361-1437
US

V. Phone/Fax

Practice location:
  • Phone: 308-635-3089
  • Fax:
Mailing address:
  • Phone: 308-641-8368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2980
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1567
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3835
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: