Healthcare Provider Details

I. General information

NPI: 1003731282
Provider Name (Legal Business Name): SJT PEDIATRIC COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7121 A ST STE 202
LINCOLN NE
68510-4289
US

IV. Provider business mailing address

11635 A ST
WALTON NE
68461-9637
US

V. Phone/Fax

Practice location:
  • Phone: 402-802-6538
  • Fax:
Mailing address:
  • Phone: 402-802-6538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHELBY CONRAD
Title or Position: OWNER
Credential: LMHP
Phone: 402-802-6538