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General NPI Number Information
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NPI Number | 1073491288
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Entity Type | Individual
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Provider Name | KATHERINE MARIE SHANMUGAM MSW, PLMHP, PCMSW
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 8998 L ST STE 110
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City | OMAHA
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State | NE
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Zip | 68127-1400
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Country | US
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Telephone | 402-651-5404
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Fax |
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Provider Business Mailing Address
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Address Line | 16704 S ST
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City | OMAHA
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State | NE
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Zip | 68135-2308
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Country | US
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Telephone | 402-679-1771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8269
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14578
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License Number State | NE
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