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General NPI Number Information
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NPI Number | 1306997986
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Entity Type | Individual
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Provider Name | JONATHAN CARL METSCHKE M.A.-LMHP
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 510 BRADFORD ST
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City | SEWARD
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State | NE
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Zip | 68434-1708
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Country | US
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Telephone | 402-643-0535
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Fax | 402-643-0540
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Provider Business Mailing Address
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Address Line | 2979 LITTLE SALT RD
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City | SEWARD
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State | NE
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Zip | 68434-7803
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Country | US
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Telephone | 402-646-2240
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Fax | 402-646-2240
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3522
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1769
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License Number State | NE
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