Healthcare Provider Details

I. General information

NPI: 1295085769
Provider Name (Legal Business Name): ASHLEE M RICHARDS MSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BRADFORD ST STE B
SEWARD NE
68434-1708
US

IV. Provider business mailing address

5600 S 59TH ST STE 104
LINCOLN NE
68516-2387
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-0595
  • Fax: 402-484-6306
Mailing address:
  • Phone: 402-484-0595
  • Fax: 402-484-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-1075
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9781
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: