Healthcare Provider Details

I. General information

NPI: 1497675250
Provider Name (Legal Business Name): MORGAN KIMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 S 133RD PLZ
OMAHA NE
68144-5905
US

IV. Provider business mailing address

7107 S 81ST ST
LA VISTA NE
68128-2165
US

V. Phone/Fax

Practice location:
  • Phone: 402-620-6652
  • Fax: 402-620-6654
Mailing address:
  • Phone: 402-431-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15010
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: