Healthcare Provider Details

I. General information

NPI: 1124152996
Provider Name (Legal Business Name): CHILDREN'S SPECIALTY PHYSICIAN BILLING - BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N 90TH ST STE 200 CHILDREN'S HOSPITAL & MED CENTER - BEHAVIORAL HEALTH
OMAHA NE
68114-2766
US

IV. Provider business mailing address

8200 DODGE ST CHILDREN'S HOSPITAL & MEDICAL CENTER
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-3900
  • Fax: 402-955-3920
Mailing address:
  • Phone: 402-955-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NANCY BARNA
Title or Position: BILLING COMPLIANCE MANAGER
Credential: MPA, MS, FHFMA, CPC
Phone: 402-955-6775