Healthcare Provider Details

I. General information

NPI: 1013963263
Provider Name (Legal Business Name): HEATHER LEANNE BOJANSKI LCSW, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LEANNE GRIEVES LCSW, LMHP

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

IV. Provider business mailing address

4113 S 40TH AVE
OMAHA NE
68107-1117
US

V. Phone/Fax

Practice location:
  • Phone: 402-346-8800
  • Fax: 402-977-5683
Mailing address:
  • Phone: 402-496-3841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2833
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1144
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: