Healthcare Provider Details

I. General information

NPI: 1073435731
Provider Name (Legal Business Name): NICHOLAS POWERS PLADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13750 MILLARD AVE STE 201
OMAHA NE
68137-2711
US

IV. Provider business mailing address

13750 MILLARD AVE STE 201
OMAHA NE
68137-2711
US

V. Phone/Fax

Practice location:
  • Phone: 531-800-2641
  • Fax:
Mailing address:
  • Phone: 531-800-2641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: