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General NPI Number Information
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NPI Number | 1366342057
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIVE MENTAL WELLNESS, LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 3401 N 191ST AVE
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City | ELKHORN
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State | NE
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Zip | 68022-3350
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Country | US
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Telephone | 402-915-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 N 191ST AVE
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City | ELKHORN
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State | NE
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Zip | 68022-3350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY DORFMEYER
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Credential | MS, LIMHP, LPC, LADC
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Telephone | 402-699-5929
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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 |
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License Number State |
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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 |
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License Number State |
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