Healthcare Provider Details

I. General information

NPI: 1649064841
Provider Name (Legal Business Name): A1 FAMILY PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N 8TH ST STE 418
LINCOLN NE
68508-1359
US

IV. Provider business mailing address

140 N 8TH ST STE 418
LINCOLN NE
68508-1359
US

V. Phone/Fax

Practice location:
  • Phone: 402-817-5813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ISMATT REZA NIAZI
Title or Position: PHYSICIAN, CEO
Credential: MD
Phone: 402-817-5813