Healthcare Provider Details

I. General information

NPI: 1932810082
Provider Name (Legal Business Name): JEFFREY PAUL BEBEE MAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10845 HARNEY ST
OMAHA NE
68154-2639
US

IV. Provider business mailing address

2422 S 6TH ST
OMAHA NE
68108-1722
US

V. Phone/Fax

Practice location:
  • Phone: 402-916-9421
  • Fax: 402-999-8221
Mailing address:
  • Phone: 402-913-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number13236
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: