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General NPI Number Information
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NPI Number | 1629896097
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Entity Type | Organization
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Legal Business Name | MENOUSEK PSYCHOLOGY CONSULTATION, LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 8790 F ST STE 111
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City | OMAHA
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State | NE
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Zip | 68127-1529
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Country | US
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Telephone | 402-704-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 21050 GEORGE B LAKE PKWY
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City | ELKHORN
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State | NE
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Zip | 68022-4135
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Country | US
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Telephone | 402-704-6555
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. KATHRYN MARIE MENOUSEK
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Credential | PH.D.
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Telephone | 402-704-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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