Healthcare Provider Details

I. General information

NPI: 1750242129
Provider Name (Legal Business Name): CASSIE OHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N COTTONWOOD ST
NORFOLK NE
68701-4210
US

IV. Provider business mailing address

512 W PHILLIP AVE
NORFOLK NE
68701-5208
US

V. Phone/Fax

Practice location:
  • Phone: 402-644-2546
  • Fax:
Mailing address:
  • Phone: 402-644-2500
  • Fax: 402-644-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number20240001148
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: