Healthcare Provider Details

I. General information

NPI: 1184254096
Provider Name (Legal Business Name): AMY SCHANTZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E GRANT ST
WEST POINT NE
68788-1816
US

IV. Provider business mailing address

221 E GRANT ST
WEST POINT NE
68788-1816
US

V. Phone/Fax

Practice location:
  • Phone: 402-309-0977
  • Fax: 888-841-4045
Mailing address:
  • Phone: 402-309-0977
  • Fax: 888-841-4045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMY K SCHANTZ
Title or Position: MENTAL HEALTH THERAPIST
Credential: PLMHP
Phone: 402-309-0977