Healthcare Provider Details

I. General information

NPI: 1851961296
Provider Name (Legal Business Name): GRETCHEN BJERKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 S 160TH ST STE 301
OMAHA NE
68130-1755
US

IV. Provider business mailing address

17411 DAYTON CIR
OMAHA NE
68135-2685
US

V. Phone/Fax

Practice location:
  • Phone: 505-417-5461
  • Fax: 531-999-2300
Mailing address:
  • Phone: 505-385-0439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3620
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3620
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: