Healthcare Provider Details

I. General information

NPI: 1922172105
Provider Name (Legal Business Name): BRADLY M. SHAY LIMHP, LADC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4719 PRESCOTT AVE
LINCOLN NE
68506-5456
US

IV. Provider business mailing address

4719 PRESCOTT AVE
LINCOLN NE
68506-5456
US

V. Phone/Fax

Practice location:
  • Phone: 402-413-9147
  • Fax: 402-261-7149
Mailing address:
  • Phone: 402-413-9147
  • Fax: 402-261-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number367
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1357
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2496
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: