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General NPI Number Information
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NPI Number | 1972006856
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Entity Type | Individual
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Provider Name | TERA LYNN NEWCOMBE
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Gender | Female
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1203 S 8TH ST
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City | NORFOLK
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State | NE
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Zip | 68701-5875
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Country | US
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Telephone | 402-371-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 910 W PARK AVE
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City | NORFOLK
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State | NE
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Zip | 68701-5044
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Country | US
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Telephone | 402-371-0220
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Fax | 402-644-4593
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | P-2094
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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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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