Healthcare Provider Details
I. General information
NPI: 1881605079
Provider Name (Legal Business Name): MARIA P. GOEDE LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/11/2006
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 E WALNUT ST
WEST POINT NE
68788-1424
US
IV. Provider business mailing address
130 E WALNUT ST
WEST POINT NE
68788-1424
US
V. Phone/Fax
- Phone: 402-841-7546
- Fax: 402-939-0159
- Phone: 402-841-7546
- Fax: 402-939-0159
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 1356 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 789 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: