MEDICARE: MRS. SHERRY LYNNE HUBBARD MS LIMHP MFT PC

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	101YM0800X	Mental Health Counselor	520	NE
2	101YP2500X	Professional Counselor	398	NE
3	106H00000X	Marriage & Family Therapist	65	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84862	OTHER	NE	BLUE CROSS BLUE SHIELD
2	9085	OTHER	NE	MIDLANDS CHOICE
3	7949569	OTHER	NE	AETNA

General Provider Information

NPI Number	:	1295701068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERRY LYNNE HUBBARD MS LIMHP MFT PC

Provider Business Mailing Address
First Line	:	1406 FORT CROOK RD S
Second Line	:	SUITE 401
City	:	BELLEVUE
State	:	NE
Zip	:	68005-2992
Country	:	US
Telephone Number	:	402-292-7712
Fax Number	:	402-292-0144

Provider Business Practice Location Address
First Line	:	1406 FORT CROOK RD S
Second Line	:	SUITE 401
City	:	BELLEVUE
State	:	NE
Zip	:	68005-2992
Country	:	US
Telephone Number	:	402-292-7712
Fax Number	:	402-292-0144

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	02/02/2024

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