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General NPI Number Information
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NPI Number | 1689843716
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Entity Type | Individual
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Provider Name | KIM SCHENKELBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 4939 S 118TH ST
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City | OMAHA
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State | NE
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Zip | 68137-2213
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Country | US
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Telephone | 402-431-8725
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Fax | 402-232-7750
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Provider Business Mailing Address
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Address Line | 10832 OLD MILL RD
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City | OMAHA
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State | NE
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Zip | 68154-2672
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Country | US
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Telephone | 402-250-5466
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3753
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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 | 1376
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License Number State | NE
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