Healthcare Provider Details

I. General information

NPI: 1770806812
Provider Name (Legal Business Name): NORTHEAST NEBRASKA PSYCHOLOGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N ENGDAHL AVE
OAKLAND NE
68045-1431
US

IV. Provider business mailing address

PO BOX 163
OAKLAND NE
68045-0163
US

V. Phone/Fax

Practice location:
  • Phone: 402-685-5116
  • Fax: 402-685-5817
Mailing address:
  • Phone: 402-685-5116
  • Fax: 402-685-5817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number733
License Number StateNE

VIII. Authorized Official

Name: DR. LINDA A HUNTER
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 402-870-1864