Healthcare Provider Details

I. General information

NPI: 1336466697
Provider Name (Legal Business Name): MAAS PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W LAKESHORE DR
LINCOLN NE
68528-1039
US

IV. Provider business mailing address

402 W LAKESHORE DR
LINCOLN NE
68528-1039
US

V. Phone/Fax

Practice location:
  • Phone: 402-432-4363
  • Fax:
Mailing address:
  • Phone: 402-432-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MISS TERESA JEAN MAAS
Title or Position: OWNER/DIRECTOR
Credential: LIMHP
Phone: 402-432-4363