Healthcare Provider Details

I. General information

NPI: 1659953396
Provider Name (Legal Business Name): TAHRA LEE BROWN MA, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 F ST
OMAHA NE
68117-2807
US

IV. Provider business mailing address

5115 F ST
OMAHA NE
68117-2807
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-9866
  • Fax: 402-397-1404
Mailing address:
  • Phone: 402-397-9866
  • Fax: 402-397-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5886
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: