Healthcare Provider Details

I. General information

NPI: 1295271302
Provider Name (Legal Business Name): NATASHA M GARTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

IV. Provider business mailing address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-2218
  • Fax: 402-489-3666
Mailing address:
  • Phone: 402-489-2218
  • Fax: 402-489-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2285
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-1345
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4746
License Number StateNE

VIII. Authorized Official

Name: NATASHA M GARTIN
Title or Position: MENTAL HEALTH THERAPIST
Credential: LMHP LPC PLADC
Phone: 402-216-9955