Healthcare Provider Details

I. General information

NPI: 1487227955
Provider Name (Legal Business Name): SHELBY CONRAD LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7121 A ST STE 102
LINCOLN NE
68510-4289
US

IV. Provider business mailing address

11635 A ST
WALTON NE
68461-9637
US

V. Phone/Fax

Practice location:
  • Phone: 402-709-8338
  • 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 Number12697
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: