Healthcare Provider Details

I. General information

NPI: 1871422048
Provider Name (Legal Business Name): CHARNEA HENLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8055 O ST STE 119B
LINCOLN NE
68510-2565
US

IV. Provider business mailing address

2920 FLETCHER AVE APT 183
LINCOLN NE
68504-1191
US

V. Phone/Fax

Practice location:
  • Phone: 855-494-1830
  • Fax:
Mailing address:
  • Phone: 531-220-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: