Healthcare Provider Details

I. General information

NPI: 1407113731
Provider Name (Legal Business Name): STEPHANIE ROGERS LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

V. Phone/Fax

Practice location:
  • Phone: 531-500-3661
  • Fax:
Mailing address:
  • Phone: 402-489-2218
  • Fax: 402-489-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2329
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4871
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: