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General NPI Number Information
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NPI Number | 1184635047
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Entity Type | Organization
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Legal Business Name | ORIGINS BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 650 J ST SUITE 401, THE MILL TOWNE BUILDING
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City | LINCOLN
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State | NE
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Zip | 68508-2900
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Country | US
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Telephone | 402-477-8198
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Fax |
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Provider Business Mailing Address
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Address Line | 650 J ST SUITE 401, THE MILL TOWNE BUILDING
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City | LINCOLN
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State | NE
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Zip | 68508-2900
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Country | US
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Telephone | 402-477-8198
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. TRICIA KAY MONZON
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Credential | MA
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Telephone | 402-429-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 395
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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 | 2222
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2504
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | P-208
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License Number State | NE
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