Healthcare Provider Details

I. General information

NPI: 1639861677
Provider Name (Legal Business Name): CAITLIN ALEXIS CROSBY CLEM LIMHP, LCSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11640 ARBOR ST STE 101
OMAHA NE
68144-5007
US

IV. Provider business mailing address

11640 ARBOR ST STE 101
OMAHA NE
68144-5007
US

V. Phone/Fax

Practice location:
  • Phone: 402-303-3391
  • Fax:
Mailing address:
  • Phone: 402-303-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119476
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09931911
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4520
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: