Healthcare Provider Details

I. General information

NPI: 1447017579
Provider Name (Legal Business Name): NEW CHAPTER FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 S 111TH ST
OMAHA NE
68137-2341
US

IV. Provider business mailing address

5111 S 111TH ST
OMAHA NE
68137-2341
US

V. Phone/Fax

Practice location:
  • Phone: 402-637-6850
  • Fax:
Mailing address:
  • Phone: 402-637-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MORGAN SMITH
Title or Position: OWNER
Credential: LIMHP, CMFT
Phone: 308-390-9347