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General NPI Number Information
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NPI Number | 1356553259
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Entity Type | Individual
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Provider Name | ANNETTE C MARVIN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 1000 S 13TH ST
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City | LINCOLN
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State | NE
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Zip | 68508-3533
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Country | US
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Telephone | 402-475-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 S 16TH ST
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City | LINCOLN
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State | NE
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Zip | 68502-3704
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Country | US
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Telephone | 402-481-5268
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | P-1977
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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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 | 12924
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License Number State | NE
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