=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861356115
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRUNDMAYER PSYCHOTHERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2025
-----------------------------------------------------
Last Update Date | 01/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5935 S 56TH ST STE B
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-3307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-413-9556
-----------------------------------------------------
Fax | 531-324-2190
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7910 S 69TH ST
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-3535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-413-9556
-----------------------------------------------------
Fax | 531-324-2190
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOTHERAPIST
-----------------------------------------------------
Name | ASHLEY LYNN GRUNDMAYER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-413-9556
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------