Healthcare Provider Details

I. General information

NPI: 1134276793
Provider Name (Legal Business Name): ROBERT GALL LMHP, LPC, LADC, MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 GILES RD SUITE 4
LAVISTA NE
68128-6060
US

IV. Provider business mailing address

7202 GILES RD SUITE 4
LAVISTA NE
68128-6060
US

V. Phone/Fax

Practice location:
  • Phone: 402-612-3816
  • Fax: 402-614-4130
Mailing address:
  • Phone: 402-612-3816
  • Fax: 402-614-4130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number583
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2250
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1255
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: