MEDICARE: STEVEN BOMAN, MA, LMHP, CMFT

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	106H00000X	Marriage & Family Therapist	4783	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	:	1356892764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN BOMAN, MA, LMHP, CMFT

Provider Business Mailing Address
First Line	:	1299 FARNAM ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-1880
Country	:	US
Telephone Number	:	402-997-0666
Fax Number	:	877-839-2161

Provider Business Practice Location Address
First Line	:	1299 FARNAM ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-1880
Country	:	US
Telephone Number	:	402-997-0666
Fax Number	:	877-839-2161

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN BOMAN
Credential	:
Telephone Number	:	402-997-0666

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	10/20/2016

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