Healthcare Provider Details

I. General information

NPI: 1578026035
Provider Name (Legal Business Name): ALYSSA SMITH LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12608 S 74TH ST
PAPILLION NE
68046-4887
US

IV. Provider business mailing address

12608 S 74TH ST
PAPILLION NE
68046-4887
US

V. Phone/Fax

Practice location:
  • Phone: 402-783-1150
  • Fax:
Mailing address:
  • Phone: 402-783-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: