Healthcare Provider Details

I. General information

NPI: 1649236597
Provider Name (Legal Business Name): COLLEEN M STORTVEDT LIMHP, CPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5401
US

IV. Provider business mailing address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5401
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 Code101YP2500X
TaxonomyProfessional Counselor
License Number1252
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2244
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: