Healthcare Provider Details

I. General information

NPI: 1033206768
Provider Name (Legal Business Name): WILLIAM K OHLMEYER JR. LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SOUTH 13TH STREET
NORFOLK NE
68701
US

IV. Provider business mailing address

1308 GALETA AVE APT B
NORFOLK NE
68701
US

V. Phone/Fax

Practice location:
  • Phone: 402-370-3140
  • Fax: 402-370-3373
Mailing address:
  • Phone: 402-672-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number459
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: