Healthcare Provider Details

I. General information

NPI: 1629705892
Provider Name (Legal Business Name): MCDEVITT BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2022
Last Update Date: 08/06/2022
Certification Date: 08/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7130 S 29TH ST STE G
LINCOLN NE
68516-5841
US

IV. Provider business mailing address

7130 S 29TH ST STE G
LINCOLN NE
68516-5841
US

V. Phone/Fax

Practice location:
  • Phone: 402-413-6537
  • Fax:
Mailing address:
  • Phone: 402-413-6537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MCDEVITT
Title or Position: PRESIDENT
Credential: LIMHP, LADC
Phone: 402-677-6716