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NPI Code Detail

MEDICARE: ORENDA PSYCHOTHERAPY

MEDICARE: ORENDA PSYCHOTHERAPY
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1194363432
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORENDA PSYCHOTHERAPY
Provider Business Mailing Address
First Line : 2921 N 70TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68507-2713
Country : US
Telephone Number : 402-910-0479
Fax Number :
Provider Business Practice Location Address
First Line : 4701 VAN DORN ST STE B
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2511
Country : US
Telephone Number : 402-910-0479
Fax Number :
Authorized Official
Title or Position : SOCIAL WORKER, CLINICAL
Name : SARA GASPER
Credential : PCMSW, PLMHP
Telephone Number : 402-910-0479
Provider Enumeration Date : 12/17/2019
Last Update Date : 12/17/2019

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Directions to “ORENDA PSYCHOTHERAPY ” Practice Location

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