Healthcare Provider Details

I. General information

NPI: 1932032190
Provider Name (Legal Business Name): NICHOLE HENSLEY LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 4TH CORSO
NEBRASKA CITY NE
68410-2679
US

IV. Provider business mailing address

206 N 2ND ST
DUNBAR NE
68346-3042
US

V. Phone/Fax

Practice location:
  • Phone: 402-597-2947
  • Fax: 402-590-2030
Mailing address:
  • Phone: 402-874-0322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1694
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: