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General NPI Number Information
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NPI Number | 1851350904
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Entity Type | Individual
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Provider Name | TERRY ELLEN STEWART-DESECK LIMHP, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/18/2006
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 201 GALVIN RD N
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City | BELLEVUE
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State | NE
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Zip | 68005-4852
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Country | US
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Telephone | 402-779-1316
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Fax |
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Provider Business Mailing Address
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Address Line | 7516 S 30TH ST
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City | BELLEVUE
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State | NE
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Zip | 68147-1312
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Country | US
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Telephone | 785-233-7962
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 777
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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 | 1377
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1377
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License Number State | NE
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