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General NPI Number Information
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NPI Number | 1720408602
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Entity Type | Organization
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Legal Business Name | ADVANCED PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 06/05/2021
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Provider Practice Location Address
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Address Line | 1919 S 40TH ST STE 206
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City | LINCOLN
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State | NE
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Zip | 68506-5247
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Country | US
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Telephone | 402-540-2973
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Fax | 888-959-0716
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Provider Business Mailing Address
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Address Line | 1919 S 40TH ST STE 206
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City | LINCOLN
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State | NE
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Zip | 68506-5247
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Country | US
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Telephone | 402-540-2973
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Fax | 888-959-0716
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Authorized Official
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Title or Position | OWNER
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Name | MR. SETH BROWN
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Credential | LIMHP
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Telephone | 402-540-2973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 576
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License Number State | NE
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