Healthcare Provider Details

I. General information

NPI: 1881921856
Provider Name (Legal Business Name): STEPHANIE LYNN PICKERT M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8545 PARK DR
RALSTON NE
68127-3621
US

IV. Provider business mailing address

8545 PARK DR
OMAHA NE
68127-3621
US

V. Phone/Fax

Practice location:
  • Phone: 402-331-4700
  • Fax:
Mailing address:
  • Phone: 402-331-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: