Healthcare Provider Details

I. General information

NPI: 1528993219
Provider Name (Legal Business Name): LAURA JENKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11930 ARBOR ST STE 201
OMAHA NE
68144-2998
US

IV. Provider business mailing address

11930 ARBOR ST STE 201
OMAHA NE
68144-2998
US

V. Phone/Fax

Practice location:
  • Phone: 402-287-4927
  • Fax:
Mailing address:
  • Phone: 402-287-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14938
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: