Healthcare Provider Details

I. General information

NPI: 1033271739
Provider Name (Legal Business Name): REBECCA L DACUS LMHP, PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 CORNHUSKER HWY
LINCOLN NE
68504-1534
US

IV. Provider business mailing address

3940 CORNHUSKER HWY
LINCOLN NE
68504-1534
US

V. Phone/Fax

Practice location:
  • Phone: 402-464-8866
  • Fax: 402-464-8879
Mailing address:
  • Phone: 402-464-8866
  • Fax: 402-464-8879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2909
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: