Healthcare Provider Details

I. General information

NPI: 1073004586
Provider Name (Legal Business Name): NAVIGATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 07/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 NORMAL BLVD STE 142
LINCOLN NE
68506
US

IV. Provider business mailing address

4535 NORMAL BLVD STE 142
LINCOLN NE
68506-2891
US

V. Phone/Fax

Practice location:
  • Phone: 402-438-6353
  • Fax:
Mailing address:
  • Phone: 402-601-8154
  • Fax: 402-261-8263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1025
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: THOMAS L DIERKS
Title or Position: PROVIDER
Credential: LCSW
Phone: 402-601-8154