Healthcare Provider Details

I. General information

NPI: 1093649030
Provider Name (Legal Business Name): NATHAN DANIEL PISKORSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 N 163RD PLZ UNIT 6
OMAHA NE
68116-2109
US

IV. Provider business mailing address

12016 WILLIAM PLZ APT 115
OMAHA NE
68144-1542
US

V. Phone/Fax

Practice location:
  • Phone: 402-513-4416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14914
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: