=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609252089
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORR PSYCHOTHERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2015
-----------------------------------------------------
Last Update Date | 08/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5600 S 59TH ST
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-2386
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-484-0595
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5600 S 59TH ST
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-2386
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-484-0595
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CHRISTOPHER ORR
-----------------------------------------------------
Credential | LMHP
-----------------------------------------------------
Telephone | 402-484-0595
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 756
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------