Healthcare Provider Details

I. General information

NPI: 1063356335
Provider Name (Legal Business Name): HALEY ELIZABETH TIMMERMANS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HALEY ELIZABETH JESSEN

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4804 SARATOGA ST
OMAHA NE
68104-2343
US

IV. Provider business mailing address

4804 SARATOGA ST
OMAHA NE
68104-2343
US

V. Phone/Fax

Practice location:
  • Phone: 402-490-5678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2597
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: