Healthcare Provider Details

I. General information

NPI: 1992844039
Provider Name (Legal Business Name): PATRICK J SAILORS MA LIMHP LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2444 O STREET
LINCOLN NE
68510
US

IV. Provider business mailing address

2444 O STREET
LINCOLN NE
68510
US

V. Phone/Fax

Practice location:
  • Phone: 402-475-7666
  • Fax: 402-476-9623
Mailing address:
  • Phone: 402-475-7666
  • Fax: 402-476-9623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1506
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: