Healthcare Provider Details

I. General information

NPI: 1548176001
Provider Name (Legal Business Name): KATHRYN KIRSCHBAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 J ST STE 100
LINCOLN NE
68508-2915
US

IV. Provider business mailing address

6140 NW 2ND CIR APT 421
LINCOLN NE
68521-4455
US

V. Phone/Fax

Practice location:
  • Phone: 402-617-6849
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15066
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: