Healthcare Provider Details

I. General information

NPI: 1376447607
Provider Name (Legal Business Name): PURPOSEFUL PATHWAYS BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14936 LAFAYETTE PLZ
OMAHA NE
68154-1045
US

IV. Provider business mailing address

14936 LAFAYETTE PLZ
OMAHA NE
68154-1045
US

V. Phone/Fax

Practice location:
  • Phone: 402-512-3086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: KALLY L SORENSEN
Title or Position: OWNER/ PROVIDER
Credential: BCBA
Phone: 402-512-3086