=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790652840
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MINDSIGHT BEHAVIORAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2025
-----------------------------------------------------
Last Update Date | 10/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8750 S 30TH ST APT 247
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-6079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-613-8375
-----------------------------------------------------
Fax | 531-324-2215
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8750 S 30TH ST APT 247
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-6079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-613-8375
-----------------------------------------------------
Fax | 531-324-2215
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. DULCE ELIZABETH CLARENCE
-----------------------------------------------------
Credential | LIMHP, LMHC
-----------------------------------------------------
Telephone | 402-613-8375
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------