Healthcare Provider Details

I. General information

NPI: 1265377527
Provider Name (Legal Business Name): MARCIA STEPHENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 S 70TH ST STE 105
LINCOLN NE
68506-1563
US

IV. Provider business mailing address

839 GOODHUE BLVD
LINCOLN NE
68508-4337
US

V. Phone/Fax

Practice location:
  • Phone: 402-243-0650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6465
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: