Healthcare Provider Details

I. General information

NPI: 1467287607
Provider Name (Legal Business Name): UNIQUE ATWATER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8922 CUMING ST
OMAHA NE
68114-2732
US

IV. Provider business mailing address

8300 JEFFERSON ST NE STE B
ALBUQUERQUE NM
87113-1734
US

V. Phone/Fax

Practice location:
  • Phone: 402-926-4373
  • Fax:
Mailing address:
  • Phone: 844-272-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14964
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: