Healthcare Provider Details

I. General information

NPI: 1588629612
Provider Name (Legal Business Name): OASIS COUNSELING INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5221
US

IV. Provider business mailing address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5221
US

V. Phone/Fax

Practice location:
  • Phone: 402-379-2030
  • Fax: 402-379-3933
Mailing address:
  • Phone: 402-379-2030
  • Fax: 402-379-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK E STORTVEDT
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 402-379-2030