Healthcare Provider Details

I. General information

NPI: 1124846969
Provider Name (Legal Business Name): COURTNEY SCARPINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY HANSEN

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 N 14TH AVE
OMAHA NE
68110-1134
US

IV. Provider business mailing address

5618 N 14TH AVE
OMAHA NE
68110-1134
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-2060
  • Fax:
Mailing address:
  • Phone: 531-299-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13519
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: