Healthcare Provider Details

I. General information

NPI: 1619040862
Provider Name (Legal Business Name): HOLLIE J URBAUER M.A.,LMHP, LADC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5561 S 48TH ST STE 201I
LINCOLN NE
68516-4133
US

IV. Provider business mailing address

5561 S 48TH ST STE 201I
LINCOLN NE
68516-4133
US

V. Phone/Fax

Practice location:
  • Phone: 402-310-8323
  • Fax:
Mailing address:
  • Phone: 402-310-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11019
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number776
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: