MEDICARE: CELESTE L HEAIVILIN

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	7068	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326185505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE L HEAIVILIN

Provider Business Mailing Address
First Line	:	312 N ELM ST STE 108
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-4509
Country	:	US
Telephone Number	:	308-227-9271
Fax Number	:	308-381-7970

Provider Business Practice Location Address
First Line	:	3180 W HIGHWAY 34
Second Line	:	AHEC OFFICE
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-7279
Country	:	US
Telephone Number	:	308-385-6428
Fax Number	:	308-385-6414

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/25/2023

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Directions to “ CELESTE L HEAIVILIN ” Practice Location

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