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General NPI Number Information
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NPI Number | 1700713799
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Entity Type | Organization
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Legal Business Name | EMERALD PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/10/2026
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Provider Practice Location Address
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Address Line | 4316 S 48TH ST STE 2
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City | LINCOLN
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State | NE
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Zip | 68516-1287
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Country | US
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Telephone | 402-235-9224
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Fax | 402-226-8894
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Provider Business Mailing Address
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Address Line | 4316 S 48TH ST STE 2
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City | LINCOLN
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State | NE
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Zip | 68516-1287
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Country | US
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Telephone | 402-235-9224
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Fax | 402-226-8894
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Authorized Official
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Title or Position | OWNER, MENTAL HEALTH THERAPIST
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Name | CONNOR SULLIVAN
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Credential | MSW, PLMHP, PCMSW
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Telephone | 402-570-2078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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