MEDICARE: MRS. KELLY LYNN BETTS HANNY LIMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7365	NE
2	101YM0800X	Mental Health Counselor	11857	NE

General Provider Information

NPI Number	:	1023676285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY LYNN BETTS HANNY LIMHP

Provider Business Mailing Address
First Line	:	11837 MIRACLE HILLS DR STE 205
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-4418
Country	:	US
Telephone Number	:	402-736-6340
Fax Number	:

Provider Business Practice Location Address
First Line	:	11837 MIRACLE HILLS DR STE 205
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-4418
Country	:	US
Telephone Number	:	402-736-6340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2019
Last Update Date	:	08/22/2024

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