Healthcare Provider Details

I. General information

NPI: 1568377745
Provider Name (Legal Business Name): TESS CORRINE GOLDSMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 THOMPSON CREEK BLVD STE 3
LINCOLN NE
68516-6579
US

IV. Provider business mailing address

5701 BOBOLI LN UNIT 423
LINCOLN NE
68516-3511
US

V. Phone/Fax

Practice location:
  • Phone: 402-327-1085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15055
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: